Management of low-risk early-stage cervical cancer: Should conization, simple trachelectomy, or simple hysterectomy replace radical surgery as the new standard of care?
Identifieur interne : 003428 ( Main/Exploration ); précédent : 003427; suivant : 003429Management of low-risk early-stage cervical cancer: Should conization, simple trachelectomy, or simple hysterectomy replace radical surgery as the new standard of care?
Auteurs : Pedro T. Ramirez [États-Unis] ; Rene Pareja [Colombie] ; Gabriel J. Rend N [Colombie] ; Carlos Millan [Espagne] ; Michael Frumovitz [États-Unis] ; Kathleen M. Schmeler [États-Unis]Source :
- Gynecologic oncology [ 0090-8258 ] ; 2013.
Abstract
The standard treatment for women with early-stage cervical cancer (IA2-IB1) remains radical hysterectomy with pelvic lymphadenectomy. In select patients interested in future fertility, the option of radical trachelectomy with pelvic lymphadenectomy is also considered a viable option. The possibility of less radical surgery may be appropriate not only for patients desiring to preserve fertility but also for all patients with low-risk early-stage cervical cancer. Recently, a number of studies have explored less radical surgical options for early-stage cervical cancer, including simple hysterectomy, simple trachelectomy, and cervical conization with or without sentinel lymph node biopsy and pelvic lymph node dissection. Such options may be available for patients with low-risk early-stage cervical cancer. Criteria that define this low-risk group include: squamous carcinoma, adenocarcinoma, or adenosquamous carcinoma, tumor size <2 cm, stromal invasion <10mm, and no lymph-vascular space invasion. In this report, we provide a review of the existing literature on the conservative management of cervical cancer and describe ongoing multi-institutional trials evaluating the role of conservative surgery in selected patients with early-stage cervical cancer.
Url:
DOI: 10.1016/j.ygyno.2013.09.004
PubMed: 24041877
PubMed Central: 4286394
Affiliations:
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Ramirez</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, United States</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030</wicri:regionArea><wicri:noRegion>Texas 77030</wicri:noRegion></affiliation></author><author><name sortKey="Pareja, Rene" sort="Pareja, Rene" uniqKey="Pareja R" first="Rene" last="Pareja">Rene Pareja</name><affiliation wicri:level="1"><nlm:aff id="A2">Department of Gynecologic Oncology, Instituto de Cancerología Las Américas, Medellín, Colombia</nlm:aff><country xml:lang="fr">Colombie</country><wicri:regionArea>Department of Gynecologic Oncology, Instituto de Cancerología Las Américas, Medellín</wicri:regionArea><wicri:noRegion>Medellín</wicri:noRegion></affiliation></author><author><name sortKey="Rend N, Gabriel J" sort="Rend N, Gabriel J" uniqKey="Rend N G" first="Gabriel J." last="Rend N">Gabriel J. 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Schmeler</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, United States</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030</wicri:regionArea><wicri:noRegion>Texas 77030</wicri:noRegion></affiliation></author></analytic><series><title level="j">Gynecologic oncology</title><idno type="ISSN">0090-8258</idno><idno type="eISSN">1095-6859</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p id="P2">The standard treatment for women with early-stage cervical cancer (IA2-IB1) remains radical hysterectomy with pelvic lymphadenectomy. In select patients interested in future fertility, the option of radical trachelectomy with pelvic lymphadenectomy is also considered a viable option. The possibility of less radical surgery may be appropriate not only for patients desiring to preserve fertility but also for all patients with low-risk early-stage cervical cancer. Recently, a number of studies have explored less radical surgical options for early-stage cervical cancer, including simple hysterectomy, simple trachelectomy, and cervical conization with or without sentinel lymph node biopsy and pelvic lymph node dissection. Such options may be available for patients with low-risk early-stage cervical cancer. Criteria that define this low-risk group include: squamous carcinoma, adenocarcinoma, or adenosquamous carcinoma, tumor size <2 cm, stromal invasion <10mm, and no lymph-vascular space invasion. In this report, we provide a review of the existing literature on the conservative management of cervical cancer and describe ongoing multi-institutional trials evaluating the role of conservative surgery in selected patients with early-stage cervical cancer.</p></div></front></TEI><affiliations><list><country><li>Colombie</li><li>Espagne</li><li>États-Unis</li></country></list><tree><country name="États-Unis"><noRegion><name sortKey="Ramirez, Pedro T" sort="Ramirez, Pedro T" uniqKey="Ramirez P" first="Pedro T." last="Ramirez">Pedro T. Ramirez</name></noRegion><name sortKey="Frumovitz, Michael" sort="Frumovitz, Michael" uniqKey="Frumovitz M" first="Michael" last="Frumovitz">Michael Frumovitz</name><name sortKey="Schmeler, Kathleen M" sort="Schmeler, Kathleen M" uniqKey="Schmeler K" first="Kathleen M." last="Schmeler">Kathleen M. Schmeler</name></country><country name="Colombie"><noRegion><name sortKey="Pareja, Rene" sort="Pareja, Rene" uniqKey="Pareja R" first="Rene" last="Pareja">Rene Pareja</name></noRegion><name sortKey="Rend N, Gabriel J" sort="Rend N, Gabriel J" uniqKey="Rend N G" first="Gabriel J." last="Rend N">Gabriel J. Rend N</name></country><country name="Espagne"><noRegion><name sortKey="Millan, Carlos" sort="Millan, Carlos" uniqKey="Millan C" first="Carlos" last="Millan">Carlos Millan</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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