Expert consensus
For RMS of the cervix uteri the same principles and expert consensus used for vaginal tumors should be applied. Therefore, patients should undergo cystoscopy, vaginoscopy and bimanual examination under general anesthesia in addition to an MRI scan of the abdomen and pelvis. In cases of suspicious results at the rectum, rectoscopy should be performed. Biopsies should be taken trans-vaginally by polypectomy or incisional / excisional (curettage) biopsy. Partial excision of the cervix for small pedunculated tumors would be considered a conservative resection and should be performed when applicable. Primary radical surgery including hysterectomy or pelvic exenteration are not indicated due to the good response to chemotherapy and improved organ preservation.
Similar to vaginal RMS, PRE should only be undertaken in RMS of the cervix uteri if a complete resection can be achieved in smaller tumors with preservation of organ function.