Abstract: Cervical cancer is a major world health problem and the fourth most common cancer for women, its staging is mainly based on clinical examination. The International Federation of Gynecology and Obstetrics (FIGO) released a revised new staging system of cervical cancer in October 2018, which emphasizes the metastatic status of pelvic and para-aortic lymph node. Pelvic and para-aortic lymph nodes metastasis is a main risk factor of failure in concurrent chemoradiation therapy (CCRT) in cervical cancer. Due to the key role of para-aortic lymph node status in determining the radiation field and unsatisfactory control rate in large lymph node, a surgical staging of lymph node dissection before chemoradiation therapy is utilized to personalize and optimize the effect of tumor reduction and determine the field of radiation. However, surgical staging may cause perioperative complications and delay of the radiation. Due to the lack of prospective randomized controlled trials, there is no consensus on surgical staging in cervical cancer. We review the literature of surgical staging before CCRT in patients with locally advanced cervical cancer.

Key words: Uterine cervical neoplasms, Neoplasm staging, Lymph node excision, Radiotherapy, Locally advanced cervical cancer, Concurrent chemo-radiation therapy