7
Enhanced Maximal
1A1 (negative margins): cone biopsy
Repeat cone biopsy or extrafascial
hysterectomy for positive margins
(EB, H, S)
1A1 (negative margins): cone biopsy
Repeat cone biopsy or extrafascial
hysterectomy for positive margins
(EB, H, S)
Cone biopsy plus PLND (see Discussion
in full text Guideline regarding current
evidence on FS for women desiring
fertility preservation)
(EB/CB, H, S)
OR radical trachelectomy plus PLND
(EB/CB, I, M)
Cone biopsy plus PLND
(EB/CB, H, S)
OR radical trachelectomy plus PLND
(may offer ±SLN)
(EB/CB, I, M)
Cone biopsy
c
OR extrafascial
hysterectomy
b
(extrafascial hysterectomy
OR modified radical hysterectomy plus
PLND OR if positive margins repeat
conization
d
)
(EB, H, S)
Cone biopsy
c
OR extrafascial
hysterectomy
b
(extrafascial hysterectomy
OR modified radical hysterectomy plus
pelvic LN sampling if positive margins
[may offer ± SLN] OR repeat conization
d
)
(EB, H, S)
Stage IA1 (with LVSI) and stage
IA2: modified radical hysterectomy
hysterectomy (when positive margins
on repeat cone) plus PLND ± PANB
(pelvic irradiation plus brachytherapy
[with LVSI] if patient is not eligible for
surgery)
(EB, I, M)
Stage IA1 (with LVSI) and stage IA2:
modified radical hysterectomy plus PLND
± PANB (may offer ± SLN OR pelvic
irradiation plus brachytherapy [if patient
is not eligible for surgery])
(EB, I, M)
Cone biopsy plus PLND ± para-aortic
LN sampling
c
(EB, L, W)
Radical trachelectomy plus PLND
(EB, I, M)
Cone biopsy plus PLND ± para-aortic
LN sampling
c
(EB, L, W)
Radical trachelectomy plus PLND
(EB, I, M)
Cone biopsy plus PLND ± para-aortic
LN sampling
c
(EB, L, W)
Modified radical hysterectomy plus
PLND ± para-aortic LN sampling
d
(EB, I, M)
OR pelvic RT and brachytherapy
(EB, I, M)
See above
Modified radical hysterectomy plus
PLND ± para-aortic LN sampling
d
(EB, I, M)
OR pelvic RT and brachytherapy
(EB, I, M)
