CERVICAL CANCER: NATIONAL CLINICAL PRACTICE GUIDELINES FROM THE FRENCH CERVICAL CANCER GUIDELINES GROUP
In brief
French cervical cancer guidelines issue 158 recommendations, leave 71 questions unresolved
A multidisciplinary panel produced 158 recommendations across cervical cancer care, based on evidence review and validation by 87 independent reviewers; 71 clinical questions had insufficient evidence for a recommendation. Key updates include avoiding minimally invasive hysterectomy from stage IB1 and using image-guided brachytherapy after chemoradiotherapy, but care choices still depend on the evidence gaps.
- Journal
- Journal of gynecology obstetrics and human reproduction (Q2)
- Published
- 27 October 2026
- Study design
- Practice guideline / consensus
- Evidence level
- Level 1, High (CEBM 1c)
- Authors
- Xavier Carcopino, Lobna Ouldamer, Cyrille Huchon, Pauline Asseeva, Henri Azaïs, Sofiane Bendifallah, et al.
- PMID
- 42946055
- DOI
- 10.1016/j.jogoh.2026.103314
Why clinicians should know about it
- Picked for Medical Physics (top studies of the week, 1 November 2026): Guideline includes image-guided brachytherapy and radiotherapy recommendations
Abstract
Over the past decade, cervical cancer management has evolved substantially, with major changes in surgical approach, surgical radicality, nodal staging, imaging, radiotherapy techniques, brachytherapy and systemic treatments. To harmonize practice and integrate new evidence into clinically applicable recommendations, the French Cervical Cancer Guidelines Group developed national clinical practice guidelines for the management of patients with cervical cancer. The guideline process was conducted under the auspices of the French National College of Obstetricians and Gynecologists and involved a multidisciplinary expert panel representing the French scientific societies involved in cervical cancer care. Clinical questions were formulated using the PICO framework and addressed the full continuum of care, including initial assessment, imaging, diagnostic conization, surgical nodal staging, treatment, fertility preservation, response assessment, follow-up, recurrence and specific clinical situations. Evidence was reviewed and critically appraised according to the GRADE methodology, and all recommendations were based on the 2018 FIGO staging system. External validation was performed through a two-round Delphi process involving 87 independent reviewers. Overall, 130 PICO questions generated 158 recommendations, including 35 strong and 52 weak recommendations, while no recommendation could be issued for 71 questions. Key practice-changing recommendations include the role of diagnostic conization in early-stage assessment, avoidance of minimally invasive hysterectomy from stage IB1 disease, risk-adapted surgical radicality, sentinel lymph node biopsy with ultrastaging, image-guided brachytherapy after chemoradiotherapy, and integration of PEMBROLIZUMAB in selected locally advanced or metastatic settings.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.