Prognostic factors in cervical cancer

Surgery is the standard of care for women with early stage cervical cancer; radiotherapy is the cornerstone in patients with advanced stages of disease. Recent changes in the treatment of cervical cancer involve less radical surgery in early stage cervical cancer, concomitant chemo- and radiotherapy in the adjuvant setting for early stage patients and in primary treatment for advanced stage patients. Also the role of hyperthermia has been studied, unfortunately these studies face problems with patient recruitment. Neo-adjuvant chemotherapy is investigated in patients with marginally resectable tumours. Other novel approaches involve treatment with HPV-vaccination and molecular therapy. In order to study and achieve changes in treatment, one has to subdivide patients according to their prognosis.
The studies in this thesis aim to improve the subdivision and hereby selections of patients according to the prognosis in order to use this to tailor treatment, to improve prognosis and to decrease morbidity.
We will look for new prognostic factors with the use of micro-array gene expression. In the evaluation of known prognostic factors we will let go of the classical FIGO classification and evaluate the factors according to their weight in the multivariate analyses.