The place of surgery in cervical cancer under current treatment protocols

Abstract

Health issue: cervical cancer is the most common gynecologic malignancy and the fourth most common cancer in women worldwide. In most cases, the onset of cervical cancer is the result of human papillomavirus (HPV) infection. It should be borne in mind that the evolution of the infection contributes to multiple factors that are host dependent. Compared to other gynecological cancers, cervical cancer tends to appear at a younger age, which is why the Pap test is indicated. Data sources: Fertility and Sterility, PubMed, The New England Journal of Medicine, European Journal of Obstetrics Gynecology and Reproductive Biology, the Lancet (inception to June 25, 2022), performed in an academic medical setting. Key findings: surgery plays a decisive role in the management of early-stage cervical cancer. The gold standard is the type III radical hysterectomy with bilateral pelvic lymph node dissection using the open route. Laparoscopic or robotic approach for radical hysterectomy is emerging, but more data still need to be evaluated for the use of these procedures. Fertility preserving surgery is feasible, but only when reasonably used for highly selected young patients, with no children. There are still questions about the use of less radical surgical procedures in patients with mild disease and good prognostic factors. Still, there are procedures, such as conization, trachelectomy, total hysterectomy without bilateral adnexectomy or pelvic lymph nodes, that are highly used and have good anticipated results. Purpose of review: the advances in gynecological oncology now permit the election of the best individualized treatment method for patients who have early-stage disease. This research focuses on maximizing the quality of life by minimizing morbidity for patients who are candidates for different types of surgery.