If a patient is suspected of cervical cancer, what should be done first? One is physical examination, medical history, and some basic examinations, including blood phase examination, of course, the most important is cervical biopsy, pathological diagnosis, which is biopsy, not exfoliative cell examination, with indications, the so-called indications, is suspected of early invasive cancer, must do conization. Chest X-ray. PET/CT scan is also done for patients with stage IB1 or higher. The staging of cervical cancer is somewhat different from other gynecological tumors, it is still a clinical staging that is followed. It is through clinical examination, the only methods to be examined, non-clinical methods, are X-ray, chest X-ray, and MRI/CT are not used as a basis. One is that FIGO staging is a clinical staging, while MRI/CT, including PET/CT, can only guide the treatment, it cannot be used as a basis for staging. In addition, microinfiltrating carcinoma cannot be diagnosed by biopsy, but must be diagnosed by conization, and the subsequent treatment cannot change the stage. For example, if a patient has undergone intervention or systemic chemotherapy and then staging, it is not accurate. Subsequent treatment cannot change the staging, and there is no down-staging. Of course, there is another kind of patient who is found to be a cervical cancer after simple hysterectomy, and there is no way to stage this kind of patient. Only according to the high-risk factors, how to treat the next step or not. In general, early stage patients can have surgery or radiotherapy; advanced stage patients can have concurrent radiotherapy and chemotherapy, but of course, concurrent radiotherapy and chemotherapy is a sensitizing effect, often a single drug, cisplatin, generally 40 mg per square meter. For patients with stage IA1, first of all, you can simply hysterectomy, but also if you have fertility requirements, do conization, negative margins can be observed, do not do further treatment, if it is stage IA1, there is also vascular invasion, to raise a level of treatment, is equivalent to the treatment of stage IA2, at least to do a modified radical hysterectomy plus pelvic lymph node dissection. stage IA2 The standard procedure is of course radical hysterectomy plus pelvic lymph node dissection plus sampling of the para-aortic lymph nodes, and of course radiation therapy, but radiation therapy may cause loss of ovarian function in younger patients. The first option for stage IB1 and IIA is probably surgery, and the scope of surgery is radical hysterectomy plus pelvic lymph node dissection plus abdominal para-aortic lymph node dissection; of course, pelvic radiotherapy plus intracavitary radiotherapy can be done, and if it is less than 2 cm, radical hysterectomy can be done to preserve the reproductive function. For stage IB2 and IIA, radiotherapy is the treatment of choice. After surgery or surgical treatment, what is the next step. If the adjuvant treatment is lymph node negative, the next step is to determine if there are any other risk factors, which risk factors? Is the primary tumor large? Is there deep interstitial invasion? Is there any vascular involvement? If there are, especially if there are more than two, radiotherapy will be taken, synchronized radiotherapy, positive cut edge, parametrial invasion, which is a relatively high-risk factor. Simultaneous radiotherapy is used. Often, due to the lack of careful examination, it is found that after hysterectomy, the positive disease has been seen, and then it is found to be a cervical cancer, especially an invasive cancer, if it is a stage IA1, there is no problem. If it is a stage IA1, there is no problem. If it is not a stage IA1, it is found to be an invasive cervical cancer after simple hysterectomy. What should be done? There are two options, one is radiotherapy, which patients should be treated with radiotherapy, there are high-risk factors, there is deep interstitial invasion, there is vascular invasion, choose direct radiotherapy. There is another kind of patients who have no other high-risk factors, which is a superficial cortical invasion, can be supplemented by surgery, and the scope of supplemental surgery is to cut off the upper vaginal segment and the parametrium. Of course this kind of patients should have imaging examinations, before the surgery. Surveillance of cervical cancer is how to detect it after treatment. How to find out when it recurs, or if it has been detected early. The examination includes physical examination and medical history, whether there are symptoms, and for cervical cancer cytology examination, if it is 1-2 years after surgery, cytology examination is done every 3-6 months, vaginal cytology examination is done once every 6 months for 3-5 years, and after 5 years, it is done once a year. Of course, if there are clinical indications, that is, if you find some symptoms, you can do PET/CT and MRI. Some patients have recurrence of cervical cancer, whether it is surgery or radiotherapy. What about patients with recurrence? If it is a local recurrence, without radiotherapy, radiotherapy is necessary, and the success rate can reach 40%; if it is a central recurrence after radiotherapy, that is, a central recurrence, which has not accumulated to the pelvic wall and there is still tumor on the cervix, supplementary surgery, including pelvic focal debulking, or intraoperative radiotherapy can be done. There is another kind of non-local recurrence, which is distant metastasis, including lung metastasis, etc. The first choice is chemotherapy or palliative treatment.