Treatment of locally advanced, recurrent, or metastatic cervical cancer

Background Locally advanced cervical cancer, metastasis, and relapse are major challenges for any team of an oncological gynecological tumor center. Optimal treatment is often based on multimodal therapy. A systematic review of the current literature is the basis for this article. Results In the case of locally advanced cervical cancer, the indication for performing chemoradiation and surgery in selected cases is in line with current guidelines. An alternative is neoadjuvant chemotherapy followed by surgery. Such an approach should not be used outside clinical trials. The treatment of local recurrences depends on the previous surgical or radiotherapy treatment. For selected patients, renewed surgery can be offered with curative intent. In the case of histologically proven metastasis, systemic drug therapy is the only alternative. Chemotherapy can be carried out in the form of a single or multiagent therapy. Together with immunotherapy, an improvement in overall survival can be achieved. Conclusion Multimodal treatment of advanced or recurrent cervical cancer must always be adapted to the individual patient. Data that have been obtained in recent years can used to guide individualized therapeutic decision-making.