Patients with cervical cancer should be staged according to the TNM classification and the International Federation of Gynaecology and Obstetrics (FIGO) staging should also be documented [IV, A]. LN staging is not indicated in T1a1 LVSI-negative patients but can be considered in T1a1 LVSI-positive patients. Sentinel lymph node (SLN) biopsy (without additional PLN dissection (PLND)) is recommended in this situation [IV, B].

Previous pertinent histological exams of the cervical lesion/cancer, even if diagnosed in another institution, should be revised and integrated in the final report (eg, cone biopsy and hysterectomy specimen) The Programme in PDF can be access here ( for the most updated programme version, please refer to the Searchable Programme above). The presence or absence of lymphatic vessel invasion (LVI), which may be confirmed by immunohistochemistry. The quantification of the number of lymph vascular vessels involved by tumor cells is not mandatory but advisable for future prospective studies. Radical surgery or definitive CTRT according to the disease stage as recommended outside pregnancy, if the woman decides not to preserve the pregnancy. Pregnancy termination is recommended before any treatment after the first trimester, and fetus evacuation before CTRT, if possible.The ambition of ESTRO to further reinforce radiation oncology as a core partner in multidisciplinary cancer care, and to guarantee accessible and high-value radiation therapy for all cancer patients who need it, is expressed in the society’s vision statement for 2030: ‘Radiation Oncology. Optimal Health for All, Together.’ The therapeutic effect of nodal resection/debulking is unclear and should, if possible, be followed by radiotherapy [IV, C].

Estro Support is designed to help optimise the natural detoxification of estrogen and other hormone-like chemicals your body is exposed to, including plastics, soy products and even tap water. The elective target (CTV-E) includes the obturator, internal, external and common iliac and presacral regions. The inguinal nodes should be included if the primary tumor involves the distal third of the vagina. A reduced elective target volume for EBRT without the common iliac nodes may be considered in low- and intermediate-risk T1b1 patients with negative LN and no LVSI. In case of PLN involvement indicating an increased risk of PALN spread (i.e.>2 pathological LN or involvement of common iliac region) and absence of surgical para-aortic staging, the elective target for EBRT should include the para-aortic region up to the renal vessels. In case of PALN involvement, the target volume includes at a minimum the region up to the renal vessels. Pathological macroscopic LN (GTV-N) are optimally localized with PET-CT and contoured on MRI. Combined operative-radiotherapy procedures using intra-operative radiotherapy or IGBT are an option if free surgical margins are not achievable [IV, B]. Weight gain, severe mood swings, PMS symptoms and even gynecomastia ("man boobs") can be a result of xeno-estrogens or imbalances between estrogen and other hormones for both men and women.With over 9 000 members in and outside Europe, ESTRO supports all the Radiation Oncology professionals in their daily practice: Radiation Oncologists, Medical Physicists, Radiobiologists and RTTs (Radiation Therapists) and the wider oncology community. Treatment strategy should aim to avoid combining radical surgery and radiotherapy because of the high morbidity induced by the combined treatment [IV, A]. Pathological confirmation may be obtained by colposcopy oriented biopsy or small cone (appropriate only during the first trimester of pregnancy, endocervical curettage is contraindicated) [IV, C]. Several treatment modalities are available and should be discussed with the patient taking into account the tumor stage, gestational week of pregnancy and the patient’s preferences [IV, B]: