1. Stage Ia tumors are first diagnosed by colposcopic-directed biopsy and are confirmed by cone biopsy. The prognosis is good. Five-year survival exceeds 95 percent with appropriate treatment.
2. Therapy is simple hysterectomy without pelvic lymph node dissection. Adequate cone biopsy with close follow-up is an option in women who wish to preserve their fertility and understand the potential risk of progression.
E. Stage lb and lla tumors are diagnosed clinically and can be treated surgically or with radiotherapy. Both treatments produce similar results, with a five-year survival rate of 80 to 90 percent. Surgery includes a radical hysterectomy. Oophorectomy is not necessary in premenopausal women.
F. Stage llb, Ill and IV tumors. Once the tumor extends to or invades local organs, radiation therapy becomes the mainstay of treatment. This therapy provides five-year survival rates of 65, 40 and less than 20 percent for stages 11 b, III and IV, respectively. Patients with distant metastases (stage IVb) also require chemotherapy to control systemic disease.
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