Japan Society of Gynecologic Oncology guidelines 2017 for the treatment of uterine cervical cancer
The Japan Society of Gynecologic Oncology (JSGO) Guidelines 2017 for the Treatment of Uterine Cervical Cancer are for the purpose of providing standard treatment strategies for cervical cancer, indicating treatment methods currently considered appropriate for cervical cancer, minimizing variances in treatment methods among institutions, improving the safety of treatment and prognosis of diseases, reducing the economic and psychosomatic burden of patients by promoting performance of appropriate treatment, and enhancing mutual understanding between patients and healthcare professionals. The guidelines were prepared through consensus of the JSGO Guideline Committee, based on careful review of evidence gathered through the literature searches and in view of the medical health insurance system and actual clinical practice situations in Japan. The guidelines comprise eight chapters and five algorithms. The main features of the 2017 revision are as follows: (1) evidence was collected using a search formula and with cooperation of the Japan Library Association. The bibliographical search formula was placed at the end of the book; (2) regarding clinical questions (CQs) where evidence or clinical inspection in Japan was lacking, opinions of the Guidelines Committee were described as “proposals for future directions”; (3) cervical intraepithelial neoplasia (CIN) 3 and adenocarcinoma in situ (AIS) were treated as a cervical precancerous lesion; (4) the CQs of endoscopic surgery, radical trachelectomy, and sentinel node biopsy were newly added in Chapter 3, “primary treatment for stage IB–II cervical cancer”; and (5) the CQ about hormone replacement therapy after cancer treatment was newly established. Each recommendation is accompanied by a classification of recommendation categories based on the consensus reached by the Guideline Committee members. Here, we present the English version of the JSGO Guidelines 2017 for the Treatment of Uterine Cervical Cancer.
KeywordsUterine cervical cancer Clinical practice guidelines Surgery Chemotherapy Irradiation Recurrence
Adenocarcinoma in situ
Cervical intraepithelial neoplasia
Conflicts of interests
Clinical target volume
European Organization for Research and Treatment of Cancer
International Federation of Gynecology and Obstetrics
Hormone replacement therapy
High-grade squamous intraepithelial lesion
Intensity-modulated radiation therapy
Japan Clinical Oncology Group
Japanese Gynecologic Oncology Group
Japan Society of Clinical Oncology
Japan Society of Gynecologic Oncology
Low-grade squamous intraepithelial lesion
Medical Information Network Distribution Service
National Comprehensive Cancer Network
Planning target volume
Quality of life
Randomized controlled trial
Radiation Therapy Oncology Group
Squamous intraepithelial lesion
Paclitaxel plus carboplatin
Paclitaxel plus cisplatin
Whole-brain radiation therapy
World Health Organization
3 dimensional-conformal radiotherapy
We thank the Japanese Society of Obstetrics and Gynecology (JSOG), the Japan Society of Clinical Oncology (JSCO), the Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy, the Japanese Gynecologic Oncology Group (JGOG), the Japan Association of Obstetricians and Gynecologists (JAOG), the Japan Society of Pathology (JSP), the Japanese Society for Radiation Oncology (JASTRO) for their comments and contributions throughout the project. We also acknowledge the clerical and technical assistance by Ms Toshie Yasuda of JSGO and Ms Yuriko Adachi of Kanehara CO., LTD.
Members of Guidelines Committee (alphabetical order)
Masanori Kaneuchi, Hidetaka Katabuchi, Mikio Mikami, Satoru Nagase, Tsutomu Tabata. Yasuhiro Udagawa, Nobuo Yaegashi.
Members of guidelines drafting committee (alphabetical order)
Tsukasa Baba, Yasuhiko Ebina, Takayuki Enomoto, Kazuhiko Hayashi, Yasuyuki Hirashima, Takashi Iwata, Shingo Kato, Noriyuki Katsumata, Atsumi Kojima, Tetsuji Kurokawa, Masaki Mandai, Yoshiki Mikami, Toshinari Muramatsu, Yutaka Nagai, Hidekatsu Nakai, Kentaro Nakayama, Hitoshi Niikura, Katsutoshi Oda, Hideyuki Ohtake, Masayuki Sekine, Muneaki Shimada, Tsutomu Tabata, Kiyomi Takaishi, Kiyoshi Takamatsu, Kazuhiro Takehara, Hironori Tashiro, Takafumi Toita, Satoshi Yamaguchi, Masanori Yasuda, Kiyoshi Yoshino.
Members of guidelines evaluation committee (alphabetical order)
Daisuke Aoki, Yoichi Aoki, Takuma Fujii, Keiichi Fujiwara, Toru Hachisuga, Toshio Hamatani, Kenichi Hrano, Kazuhiko Ino, Atsuko Itakura, Kiyoshi Ito, Osamu Iwanari, Seiryu Kamoi, Takahiro Kasamatsu, Naoki Kawamura, Hiroaki Kobayashi, Hiroshi Kobayashi, Takeshi Kodaira, Kaneyuki Kubushiro, Etsuko Miyagi, Mika Mizuno, Kenichiro Morishige, Tetsuro Nagasaka, Toshiaki Nakamura, Masahide Ohmichi, Aikou Okamoto, Takashi Onda, Tsuyoshi Saito, Toshiaki Saito, Noriaki Sakuragi, Toyomi Sato, Tadashi Shiraishi, Toru Sugiyama, Nao Suzuki, Mitsuaki Suzuki, Masashi Takano, Nobuhiro Takeshima, Takashi Uno, Kimio Ushijima, Yoh Watanabe, Hiroko Yokota, Hiroyuki Yoshikawa.
Patient advocacy group “Katorea no Mori”.
Preparation of these guidelines was funded by the JSGO. No financial support was received from any other organization or corporation.
Compliance with ethical standards
Conflict of interest
(1) The Conflicts of Interest Committee of the JSGO discloses information on real or potential COIs of the members of the Drafting and Evaluation Committees for the Guidelines, as well as other relevant parties. The information can be confirmed via the Policy on Conflicts of Interest among Clinical Cancer Researchers, which can be viewed at http://www.jsgo.or.jp/topics/index01.html (prepared by JSGO; in Japanese). The following corporations were disclosed by self‑declaration of the Drafting Committee members. ASKA Pharmaceutical Co., Ltd.; Otsuka Pharmaceutical Co., Ltd.; TSUMURA & Co.; Zeria Pharmaceutical Co., Ltd.; Chugai Pharmaceutical Co., Ltd.; Bayer Yakuhin Ltd.; Pfizer Japan Inc.; and Roche Diagnostics Co., Ltd. (2) Each recommendation was determined through consensus of all committee members and was not influenced by the interests of specific organizations, products, or technologies.
- 1.National Cancer Center, Japan (2016) Cancer registry and statistics. Ministry of Health, Labour and Welfare, TokyoGoogle Scholar
- 6.Fukui T, Yoshida M, Yamaguchi N et al (2007) Minds handbook on preparation of treatment guidelines 2007. Igaku Shoin, TokyoGoogle Scholar
- 7.Yamaguchi N, Morizane T, Kojimahara N et al (2014) Minds handbook on preparation of treatment guidelines 2014. Igaku Shoin, TokyoGoogle Scholar
- 8.Stoler M, Bergeron C, Colgan TJ et al (2014) Squmous cell tumours and precursors. In: Kurman RJ, Carcangiu ML, Herrington CS et al (ed) World Health Organization classification of tumours, 4th edn. Tumours of Female Reproductive Organs. Lyon, IARC Press, Lyon, pp 172–182Google Scholar
- 9.Japanese Society of Obstetrics and Gynecology, Japan Society of Pathology (2017) The general rules for clinicaland pathological management of uterine cervical cancer, pathological edition, 4th edn. Kanehara-shuppan, TokyoGoogle Scholar
- 11.Katabuchi H (2016) Gynecologic cancer comittee report in 2014. Acta Obstet Gynaecol Jpn 68:1117–1160Google Scholar
- 12.Cervical Cancer Guideline (Version 1) (2016) NCCN clinical practice guidelines in oncologyGoogle Scholar
- 17.Brockbank E, Kokka F, Bryant A et al (2013) Pre-treatment surgical para-aortic lymph node assessment in locally advanced cervical cancer. Cochrane Database Syst Rev 2013:CD008217Google Scholar
- 30.Japanese Society of Obstetrics and Gynecology, Japan Society of Pathology (2012) The general rules for clinical and pathological management of uterine cervical cancer, 3rd edn. Kanehara-shuppan, TokyoGoogle Scholar
- 31.Japanese Society for Radiation Oncology (2012) Guidelines of radiotherapy treatment planning 2012. Kanehara-shuppan, TokyoGoogle Scholar
- 34.Perez CA, Kavanagh BD (2008) Uterine cervix. In: Perez CA, Brady LW (eds) Principles and practice of radiation oncology, 5th edn. Lippincott Williams & Wilkins, Philadelphia, pp 1800–1915Google Scholar
- 42.Toita T, Kitagawa R, Hamano T et al (2012) Phase II study of concurrent chemoradiotherapy with high-dose-rate intracavitary brachytherapy in patients with locally advanced uterine cervical cancer: efficacy and toxicity of a low cumulative radiation dose schedule. Gynecol Oncol 126:211–216CrossRefGoogle Scholar
- 60.Lanceley A, Fiander A, McCormack et al (2013) Followup protocols for women with cervical cancer after primary treatment. Cochrane Database Syst Rev 2013:CD008767Google Scholar