Is less more in the surgical treatment of early-stage cervical cancer?

Autor: Schaafsma, Mirte, Plante, Marie, Mom, Constantijne H., van Trommel, Nienke E.
Přispěvatelé: Pathology, Obstetrics and gynaecology, CCA - Cancer Treatment and quality of life, Amsterdam Reproduction & Development (AR&D)
Rok vydání: 2022
Předmět:
Zdroj: Current Opinion in Oncology, 34(5), 473-489. Lippincott Williams and Wilkins
Schaafsma, M, Plante, M, Mom, C H & van Trommel, N E 2022, ' Is less more in the surgical treatment of early-stage cervical cancer? ', Current Opinion in Oncology, vol. 34, no. 5, pp. 473-489 . https://doi.org/10.1097/CCO.0000000000000863
ISSN: 1531-703X
1040-8746
DOI: 10.1097/cco.0000000000000863
Popis: PURPOSE OF REVIEW: This article discusses recent developments towards less radical surgical treatment for early-stage cervical cancer. RECENT FINDINGS: Surgery is the standard treatment for early-stage cervical cancer. In the last decades, new treatment strategies have been developed aiming to reduce morbidity, without hampering oncological safety. We provide an update of the latest knowledge on safety and morbidity following less radical surgical procedures in early-stage cervical cancer. In cervical cancer with a tumour size of 2 cm or less, radical surgery (simple hysterectomy or fertility-sparing conisation) may be a well tolerated option. For patients with larger lesions (>2 cm) and wishing to preserve fertility, administration of neoadjuvant chemotherapy followed by less extensive surgery appears to be a feasible and well tolerated alternative to abdominal trachelectomy. With regard to lymph node assessment, increasing evidence shows the feasibility of the sentinel lymph node procedure instead of full pelvic lymphadenectomy. Prospective trials reporting on oncological safety are awaited.It is important to exercise caution when new surgical strategies are introduced. Despite promising retrospective data, prospective randomized studies may present unexpected results, for instance, minimally invasive radical hysterectomy showed inferior results compared to laparotomy. SUMMARY: There is a shift towards less radical treatment for early-stage cervical cancer. This review explores whether and when less is really more.
Databáze: OpenAIRE
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