Skip to main content
SpringerLink
Log in

Standard and Novel Surgical Treatment in Cervical Cancer

  • Chapter
  • First Online:
Uterine Cervical Cancer

  • 929 Accesses

Abstract

Cervical cancer represents a major clinical problem as it is globally the most common malignancy of the female reproductive system and usually affects young women. The surgical management of these patients could be either conservative or radical and depends on disease stage.

More specifically, conservative surgical management (cervical conization, radical trachelectomy) is mainly used in cervical cancer patients with early-stage disease and strong desire for fertility preservation. Likewise, standard surgical management (radical hysterectomy) is preferred in cervical cancer patients with early-stage disease, who have already completed their childbearing. Moreover, salvage surgical management (pelvic exenteration, laterally extended endopelvic resection) is indicated in patients with locally advanced, persistent, or recurrent cervical cancer, who have already been treated with radiotherapy or chemoradiotherapy.

In conclusion, the type and extent of surgical treatment in these patients should be carefully individualized according to disease stage, histologic subtype, fertility issues, and performance status.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. WHO. Estimated cancer incidence, mortality and prevalence worldwide in 2012. GLOBOCAN 2012.

    Google Scholar 

  2. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359–86.

    Article  CAS  PubMed  Google Scholar 

  3. NCCN. Clinical practice guidelines in oncology: cervical cancer. NCCN.org. 2017:1–83.

    Google Scholar 

  4. ESGO. Algorithms for management of cervical cancer. ESGO.org. 2010:1–8.

    Google Scholar 

  5. Marth C, Landoni F, Mahner S, McCormack M, Gonzalez-Martin A, Colombo N. Cervical cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017;28(Suppl 4):iv72–83.

    Article  CAS  PubMed  Google Scholar 

  6. Chuang L, Temin S, Berek J. Management and care of women with invasive cervical cancer: American Society of Clinical Oncology Resource-Stratified Clinical Practice Guideline Summary. J Oncol Pract. 2016;12(7):693–6.

    Article  Google Scholar 

  7. Androutsopoulos G, Kotsopoulos I, Michail G, Decavalas G. Fertility sparing approach in young patients with early stage cervical cancer. Obstet Gynecol Int J. 2017;6(2):00197.

    Article  Google Scholar 

  8. Del Priore G. Cone biopsy. An atlas of gynecologic oncology: CRC Press; 2011. p. 68–70.

    Google Scholar 

  9. Naik R, Cross P, Nayar A, Mayadevi S, Lopes A, Godfrey K, et al. Conservative surgical management of small-volume stage IB1 cervical cancer. BJOG. 2007;114(8):958–63.

    Article  CAS  PubMed  Google Scholar 

  10. Biliatis I, Kucukmetin A, Patel A, Ratnavelu N, Cross P, Chattopadhyay S, et al. Small volume stage 1B1 cervical cancer: is radical surgery still necessary? Gynecol Oncol. 2012;126(1):73–7.

    Article  PubMed  Google Scholar 

  11. Androutsopoulos G, Kotsopoulos I, Korompelis P, Decavalas G. Does conservative surgical management of early stage cervical cancer represent a persistent dilemma in young patients? OA J Surg. 2017;3(3):555611.

    Google Scholar 

  12. Viswanathan A, Deavers M, Jhingran A, Ramirez P, Levenback C, Eifel P. Small cell neuroendocrine carcinoma of the cervix: outcome and patterns of recurrence. Gynecol Oncol. 2004;93(1):27–33.

    Article  CAS  PubMed  Google Scholar 

  13. Young R, Clement P. Endocervical adenocarcinoma and its variants: their morphology and differential diagnosis. Histopathology. 2002;41(3):185–207.

    Article  CAS  PubMed  Google Scholar 

  14. Lopes T, Spirtos N, Naik R, Monaghan J. Operations on the cervix. Bonney’s gynaecological surgery. Chichester: Wiley-Blackwell; 2010. p. 81–98.

    Book  Google Scholar 

  15. Miroshnichenko G, Parva M, Holtz D, Klemens J, Dunton C. Interpretability of excisional biopsies of the cervix: cone biopsy and loop excision. J Low Genit Tract Dis. 2009;13(1):10–2.

    Article  PubMed  Google Scholar 

  16. Fanning J, Padratzik J. Cold knife conization vs. LEEP. Are they the same procedure? J Reprod Med. 2002;47(1):33–5.

    PubMed  Google Scholar 

  17. Kim M, Kim M, Kim J, Chung H, Park N, Song Y, et al. Loop electrosurgical excision procedure findings for identification of patients with early-stage cervical cancer suitable for less radical surgery. Int J Gynecol Cancer. 2012;22(7):1214–9.

    Article  PubMed  Google Scholar 

  18. Andikyan V, Khoury-Collado F, Denesopolis J, Park K, Hussein Y, Brown C, et al. Cervical conization and sentinel lymph node mapping in the treatment of stage I cervical cancer: is less enough? Int J Gynecol Cancer. 2014;24(1):113–7.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Kyrgiou M, Koliopoulos G, Martin-Hirsch P, Arbyn M, Prendiville W, Paraskevaidis E. Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions: systematic review and meta-analysis. Lancet. 2006;367(9509):489–98.

    Article  CAS  PubMed  Google Scholar 

  20. Wright J, NathavithArana R, Lewin S, Sun X, Deutsch I, Burke W, et al. Fertility-conserving surgery for young women with stage IA1 cervical cancer: safety and access. Obstet Gynecol. 2010;115(3):585–90.

    Article  PubMed  Google Scholar 

  21. Ditto A, Martinelli F, Bogani G, Fischetti M, Di Donato V, Lorusso D, et al. Fertility-sparing surgery in early-stage cervical cancer patients: oncologic and reproductive outcomes. Int J Gynecol Cancer. 2015;25(3):493–7.

    Article  PubMed  Google Scholar 

  22. Haller H, Krasevic M, Mamula O, Brncic-Fischer A, Eminovic S, Manestar M. Treatment and outcome of stage Ia1 squamous cell carcinoma of the uterine cervix. Int J Gynaecol Obstet. 2011;113(1):72–5.

    Article  PubMed  Google Scholar 

  23. Raspagliesi F, Ditto A, Quattrone P, Solima E, Fontanelli R, Dousias V, et al. Prognostic factors in microinvasive cervical squamous cell cancer: long-term results. Int J Gynecol Cancer. 2005;15(1):88–93.

    Article  CAS  PubMed  Google Scholar 

  24. Kyrgiou M, Athanasiou A, Paraskevaidi M, Mitra A, Kalliala I, Martin-Hirsch P, et al. Adverse obstetric outcomes after local treatment for cervical preinvasive and early invasive disease according to cone depth: systematic review and meta-analysis. BMJ. 2016;354:i3633.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Nam K, Kwon J, Kim Y, Park Y. Pregnancy outcome after cervical conization: risk factors for preterm delivery and the efficacy of prophylactic cerclage. J Gynecol Oncol. 2010;21(4):225–9.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Dargent D, Brun J, Roy M, Mathevet P, Remy I. La trache’-lectomie e’largie (TE), une alternative a’ l’hyste’rectomie radicale dans le traitement des cancers infiltrants de’veloppe’s sur la face externe du col ute’rin. JOBGYN. 1994;2:285–92.

    Google Scholar 

  27. Dargent D, Martin X, Sacchetoni A, Mathevet P. Laparoscopic vaginal radical trachelectomy: a treatment to preserve the fertility of cervical carcinoma patients. Cancer. 2000;88(8):1877–82.

    Article  CAS  PubMed  Google Scholar 

  28. Smith J, Boyle D, Corless D, Ungar L, Lawson A, Del Priore G, et al. Abdominal radical trachelectomy: a new surgical technique for the conservative management of cervical carcinoma. Br J Obstet Gynaecol. 1997;104(10):1196–200.

    Article  CAS  PubMed  Google Scholar 

  29. Schneider A, Erdemoglu E, Chiantera V, Reed N, Morice P, Rodolakis A, et al. Clinical recommendation radical trachelectomy for fertility preservation in patients with early-stage cervical cancer. Int J Gynecol Cancer. 2012;22(4):659–66.

    Article  PubMed  Google Scholar 

  30. Abu-Rustum N, Sonoda Y, Black D, Levine D, Chi D, Barakat R. Fertility-sparing radical abdominal trachelectomy for cervical carcinoma: technique and review of the literature. Gynecol Oncol. 2006;103(3):807–13.

    Article  PubMed  Google Scholar 

  31. Peppercorn P, Jeyarajah A, Woolas R, Shepherd J, Oram D, Jacobs I, et al. Role of MR imaging in the selection of patients with early cervical carcinoma for fertility-preserving surgery: initial experience. Radiology. 1999;212(2):395–9.

    Article  CAS  PubMed  Google Scholar 

  32. Balleyguier C, Sala E, Da Cunha T, Bergman A, Brkljacic B, Danza F, et al. Staging of uterine cervical cancer with MRI: guidelines of the European Society of Urogenital Radiology. Eur Radiol. 2011;21(5):1102–10.

    Article  PubMed  Google Scholar 

  33. Lakhman Y, Akin O, Park K, Sarasohn D, Zheng J, Goldman D, et al. Stage IB1 cervical cancer: role of preoperative MR imaging in selection of patients for fertility-sparing radical trachelectomy. Radiology. 2013;269(1):149–58.

    Article  PubMed  Google Scholar 

  34. Diaz JP, Sonoda Y, Leitao M, Zivanovic O, Brown C, Chi D, et al. Oncologic outcome of fertility-sparing radical trachelectomy versus radical hysterectomy for stage IB1 cervical carcinoma. Gynecol Oncol. 2008;111(2):255–60.

    Article  PubMed  Google Scholar 

  35. Cao D, Yang J, Wu X, Chen Y, Li L, Liu K, et al. Comparisons of vaginal and abdominal radical trachelectomy for early-stage cervical cancer: preliminary results of a multi-center research in China. Br J Cancer. 2013;109(11):2778–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Chan K, Naik R. Advances in surgical treatment of cervical cancer. Womens Health (Lond). 2008;4(3):245–56.

    Article  Google Scholar 

  37. Ramirez P, Pareja R, Rendon G, Millan C, Frumovitz M, Schmeler K. Management of low-risk early-stage cervical cancer: should conization, simple trachelectomy, or simple hysterectomy replace radical surgery as the new standard of care? Gynecol Oncol. 2014;132(1):254–9.

    Article  PubMed  Google Scholar 

  38. Bentivegna E, Gouy S, Maulard A, Chargari C, Leary A, Morice P. Oncological outcomes after fertility-sparing surgery for cervical cancer: a systematic review. Lancet Oncol. 2016;17(6):e240–53.

    Article  PubMed  Google Scholar 

  39. Hauerberg L, Hogdall C, Loft A, Ottosen C, Bjoern S, Mosgaard B, et al. Vaginal radical trachelectomy for early stage cervical cancer. Results of the Danish National Single Center Strategy. Gynecol Oncol. 2015;138(2):304–10.

    Article  CAS  PubMed  Google Scholar 

  40. Ungar L, Palfalvi L, Hogg R, Siklos P, Boyle D, Del Priore G, et al. Abdominal radical trachelectomy: a fertility-preserving option for women with early cervical cancer. BJOG. 2005;112(3):366–9.

    Article  PubMed  Google Scholar 

  41. Lopes T, Spirtos N, Naik R, Monaghan J. Cervical cancer. Bonney's gynaecological surgery. Chichester: Wiley-Blackwell; 2010. p. 192–215.

    Book  Google Scholar 

  42. Plante M, Gregoire J, Renaud M, Roy M. The vaginal radical trachelectomy: an update of a series of 125 cases and 106 pregnancies. Gynecol Oncol. 2011;121(2):290–7.

    Article  PubMed  Google Scholar 

  43. Einstein M, Park K, Sonoda Y, Carter J, Chi D, Barakat R, et al. Radical vaginal versus abdominal trachelectomy for stage IB1 cervical cancer: a comparison of surgical and pathologic outcomes. Gynecol Oncol. 2009;112(1):73–7.

    Article  PubMed  Google Scholar 

  44. Kucukmetin A, Biliatis I, Ratnavelu N, Patel A, Cameron I, Ralte A, et al. Laparoscopic radical trachelectomy is an alternative to laparotomy with improved perioperative outcomes in patients with early-stage cervical cancer. Int J Gynecol Cancer. 2014;24(1):135–40.

    Article  PubMed  Google Scholar 

  45. Vieira M, Rendon G, Munsell M, Echeverri L, Frumovitz M, Schmeler K, et al. Radical trachelectomy in early-stage cervical cancer: a comparison of laparotomy and minimally invasive surgery. Gynecol Oncol. 2015;138(3):585–9.

    Article  PubMed  Google Scholar 

  46. Johansen G, Lonnerfors C, Falconer H, Persson J. Reproductive and oncologic outcome following robot-assisted laparoscopic radical trachelectomy for early stage cervical cancer. Gynecol Oncol. 2016;141(1):160–5.

    Article  PubMed  Google Scholar 

  47. Cibula D, Ungar L, Palfalvi L, Bino B, Kuzel D. Laparoscopic abdominal radical trachelectomy. Gynecol Oncol. 2005;97(2):707–9.

    Article  CAS  PubMed  Google Scholar 

  48. Ungar L, Palfalvi L, Boyle D, Del Priore G, Smith RJ. Radical abdominal trachelectomy. In: An atlas of gynecologic oncology: CRC Press; 2011. p. 97–104.

    Google Scholar 

  49. Wethington S, Sonoda Y, Park K, Alektiar K, Tew W, Chi DS, et al. Expanding the indications for radical trachelectomy: a report on 29 patients with stage IB1 tumors measuring 2 to 4 centimeters. Int J Gynecol Cancer. 2013;23(6):1092–8.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Plante M, Roy M. Radical vaginal trachelectomy. In: An atlas of gynecologic oncology: CRC Press; 2011. p. 88–96.

    Google Scholar 

  51. Lanowska M, Mangler M, Spek A, Grittner U, Hasenbein K, Chiantera V, et al. Radical vaginal trachelectomy (RVT) combined with laparoscopic lymphadenectomy: prospective study of 225 patients with early-stage cervical cancer. Int J Gynecol Cancer. 2011;21(8):1458–64.

    Article  PubMed  Google Scholar 

  52. Alexander-Sefre F, Chee N, Spencer C, Menon U, Shepherd J. Surgical morbidity associated with radical trachelectomy and radical hysterectomy. Gynecol Oncol. 2006;101(3):450–4.

    Article  CAS  PubMed  Google Scholar 

  53. Pareja R, Rendon G, Sanz-Lomana C, Monzon O, Ramirez P. Surgical, oncological, and obstetrical outcomes after abdominal radical trachelectomy – a systematic literature review. Gynecol Oncol. 2013;131(1):77–82.

    Article  PubMed  Google Scholar 

  54. Gien L, Covens A. Fertility-sparing options for early stage cervical cancer. Gynecol Oncol. 2010;117(2):350–7.

    Article  PubMed  Google Scholar 

  55. Okugawa K, Kobayashi H, Sonoda K, Kaneki E, Kawano Y, Hidaka N, et al. Oncologic and obstetric outcomes and complications during pregnancy after fertility-sparing abdominal trachelectomy for cervical cancer: a retrospective review. Int J Clin Oncol. 2017;22(2):340–6.

    Article  CAS  PubMed  Google Scholar 

  56. Lintner B, Saso S, Tarnai L, Novak Z, Palfalvi L, Del Priore G, et al. Use of abdominal radical trachelectomy to treat cervical cancer greater than 2 cm in diameter. Int J Gynecol Cancer. 2013;23(6):1065–70.

    Article  PubMed  Google Scholar 

  57. Speiser D, Mangler M, Kohler C, Hasenbein K, Hertel H, Chiantera V, et al. Fertility outcome after radical vaginal trachelectomy: a prospective study of 212 patients. Int J Gynecol Cancer. 2011;21(9):1635–9.

    Article  PubMed  Google Scholar 

  58. Kasuga Y, Nishio H, Miyakoshi K, Sato S, Sugiyama J, Matsumoto T, et al. Pregnancy outcomes after abdominal radical Trachelectomy for early-stage cervical Cancer: a 13-year experience in a single tertiary-care center. Int J Gynecol Cancer. 2016;26(1):163–8.

    Article  PubMed  Google Scholar 

  59. Boss E, van Golde R, Beerendonk C, Massuger L. Pregnancy after radical trachelectomy: a real option? Gynecol Oncol. 2005;99(3 Suppl 1):S152–6.

    Article  CAS  PubMed  Google Scholar 

  60. Wertheim E. Zur frag der radikaloperation beim uteruskrebs. Arch Gynakol. 1900;61:627.

    Article  Google Scholar 

  61. Dargent D, Mathevet P. Schauta's vaginal hysterectomy combined with laparoscopic lymphadenectomy. Baillieres Clin Obstet Gynaecol. 1995;9(4):691–705.

    Article  CAS  PubMed  Google Scholar 

  62. Boyle D. Radical abdominal hysterectomy. An atlas of gynecologic oncology: CRC Press, 2011:71–77.

    Google Scholar 

  63. Maneo A, Landoni F, Cormio G, Colombo A, Mangioni C. Radical hysterectomy for recurrent or persistent cervical cancer following radiation therapy. Int J Gynecol Cancer. 1999;9(4):295–301.

    Article  PubMed  Google Scholar 

  64. Landoni F, Maneo A, Colombo A, Placa F, Milani R, Perego P, et al. Randomised study of radical surgery versus radiotherapy for stage Ib-IIa cervical cancer. Lancet. 1997;350(9077):535–40.

    Article  CAS  PubMed  Google Scholar 

  65. Keys H, Bundy B, Stehman F, Muderspach L, Chafe W, Suggs C 3rd, et al. Cisplatin, radiation, and adjuvant hysterectomy compared with radiation and adjuvant hysterectomy for bulky stage IB cervical carcinoma. N Engl J Med. 1999;340(15):1154–61.

    Article  CAS  PubMed  Google Scholar 

  66. Morris M, Eifel P, Lu J, Grigsby P, Levenback C, Stevens R, et al. Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer. N Engl J Med. 1999;340(15):1137–43.

    Article  CAS  PubMed  Google Scholar 

  67. Kokka F, Bryant A, Brockbank E, Powell M, Oram D. Hysterectomy with radiotherapy or chemotherapy or both for women with locally advanced cervical cancer. Cochrane Database Syst Rev. 2015;(4):Cd010260.

    Google Scholar 

  68. Bradbury M, Founta C, Taylor W, Kucukmetin A, Naik R, Ang C. Pathological risk factors and outcomes in women with stage IB2 cervical cancer treated with primary radical surgery versus chemoradiotherapy. Int J Gynecol Cancer. 2015;25(8):1476–83.

    Article  PubMed  Google Scholar 

  69. Gaffney D, Erickson-Wittmann B, Jhingran A, Mayr N, Puthawala A, Moore D, et al. ACR appropriateness criteria(R) on advanced cervical Cancer expert panel on radiation oncology-gynecology. Int J Radiat Oncol Biol Phys. 2011;81(3):609–14.

    Article  PubMed  Google Scholar 

  70. Monk B, Tewari K, Koh W. Multimodality therapy for locally advanced cervical carcinoma: state of the art and future directions. J Clin Oncol. 2007;25(20):2952–65.

    Article  CAS  PubMed  Google Scholar 

  71. Benedetti-Panici P, Maneschi F, D'Andrea G, Cutillo G, Rabitti C, Congiu M, et al. Early cervical carcinoma: the natural history of lymph node involvement redefined on the basis of thorough parametrectomy and giant section study. Cancer. 2000;88(10):2267–74.

    Article  CAS  PubMed  Google Scholar 

  72. ConCerv trial. https://clinicaltrials.gov/ct2/show/study/NCT01048853

  73. SHAPE trial. https://clinicaltrials.gov/show/NCT01658930

  74. Landoni F, Maneo A, Cormio G, Perego P, Milani R, Caruso O, et al. Class II versus class III radical hysterectomy in stage IB-IIA cervical cancer: a prospective randomized study. Gynecol Oncol. 2001;80(1):3–12.

    Article  CAS  PubMed  Google Scholar 

  75. Marnitz S, Kohler C, Affonso R, Schneider A, Chiantera V, Tsounoda A, et al. Validity of laparoscopic staging to avoid adjuvant chemoradiation following radical surgery in patients with early cervical cancer. Oncology. 2012;83(6):346–53.

    Article  PubMed  Google Scholar 

  76. Kucukmetin A, Biliatis I, Naik R, Bryant A. Laparoscopically assisted radical vaginal hysterectomy versus radical abdominal hysterectomy for the treatment of early cervical cancer. Cochrane Database Syst Rev. 2013;(10):Cd006651.

    Google Scholar 

  77. Nam J, Park J, Kim D, Kim J, Kim Y, Kim Y. Laparoscopic versus open radical hysterectomy in early-stage cervical cancer: long-term survival outcomes in a matched cohort study. Ann Oncol. 2012;23(4):903–11.

    Article  PubMed  Google Scholar 

  78. Wang Y, Deng L, Xu H, Zhang Y, Liang Z. Laparoscopy versus laparotomy for the management of early stage cervical cancer. BMC Cancer. 2015;15:928.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Jackson K, Das N, Naik R, Lopes A, Godfrey K, Hatem M, et al. Laparoscopically assisted radical vaginal hysterectomy vs. radical abdominal hysterectomy for cervical cancer: a match controlled study. Gynecol Oncol. 2004;95(3):655–61.

    Article  CAS  PubMed  Google Scholar 

  80. Querleu D, Morrow C. Classification of radical hysterectomy. Lancet Oncol. 2008;9(3):297–303.

    Article  PubMed  Google Scholar 

  81. Cibula D, Abu-Rustum N, Benedetti-Panici P, Kohler C, Raspagliesi F, Querleu D, et al. New classification system of radical hysterectomy: emphasis on a three-dimensional anatomic template for parametrial resection. Gynecol Oncol. 2011;122(2):264–8.

    Article  CAS  PubMed  Google Scholar 

  82. Cormier B, Diaz J, Shih K, Sampson R, Sonoda Y, Park K, et al. Establishing a sentinel lymph node mapping algorithm for the treatment of early cervical cancer. Gynecol Oncol. 2011;122(2):275–80.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Lecuru F, Mathevet P, Querleu D, Leblanc E, Morice P, Darai E, et al. Bilateral negative sentinel nodes accurately predict absence of lymph node metastasis in early cervical cancer: results of the SENTICOL study. J Clin Oncol. 2011;29(13):1686–91.

    Article  PubMed  Google Scholar 

  84. Cibula D, Abu-Rustum N, Dusek L, Slama J, Zikan M, Zaal A, et al. Bilateral ultrastaging of sentinel lymph node in cervical cancer: lowering the false-negative rate and improving the detection of micrometastasis. Gynecol Oncol. 2012;127(3):462–6.

    Article  PubMed  Google Scholar 

  85. Cibula D, Velechovska P, Slama J, Fischerova D, Pinkavova I, Pavlista D, et al. Late morbidity following nerve-sparing radical hysterectomy. Gynecol Oncol. 2010;116(3):506–11.

    Article  CAS  PubMed  Google Scholar 

  86. Ditto A, Martinelli F, Hanozet F, Reato C, Solima E, Zanaboni F, et al. Class III NSRH: oncological outcome in 170 cervical cancer patients. Gynecol Oncol. 2010;119(2):192–7.

    Article  PubMed  Google Scholar 

  87. Sedlis A, Bundy B, Rotman M, Lentz S, Muderspach L, Zaino R. A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage IB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: a Gynecologic Oncology Group study. Gynecol Oncol. 1999;73(2):177–83.

    Article  CAS  PubMed  Google Scholar 

  88. Monk B, Wang J, Im S, Stock R, Peters W 3rd, Liu P, et al. Rethinking the use of radiation and chemotherapy after radical hysterectomy: a clinical-pathologic analysis of a Gynecologic Oncology Group/Southwest Oncology Group/Radiation Therapy Oncology Group trial. Gynecol Oncol. 2005;96(3):721–8.

    Article  PubMed  Google Scholar 

  89. Rotman M, Sedlis A, Piedmonte M, Bundy B, Lentz S, Muderspach L, et al. A phase III randomized trial of postoperative pelvic irradiation in stage IB cervical carcinoma with poor prognostic features: follow-up of a gynecologic oncology group study. Int J Radiat Oncol Biol Phys. 2006;65(1):169–76.

    Article  PubMed  Google Scholar 

  90. Peters W 3rd, Liu P, Barrett R 2nd, Stock R, Monk B, Berek J, et al. Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix. J Clin Oncol. 2000;18(8):1606–13.

    Article  CAS  PubMed  Google Scholar 

  91. Brunschwig A. Complete excision of pelvic viscera for advanced carcinoma; a one-stage abdominoperineal operation with end colostomy and bilateral ureteral implantation into the colon above the colostomy. Cancer. 1948;1(2):177–83.

    Article  CAS  PubMed  Google Scholar 

  92. Sardain H, Lavoue V, Redpath M, Bertheuil N, Foucher F, Leveque J. Curative pelvic exenteration for recurrent cervical carcinoma in the era of concurrent chemotherapy and radiation therapy. A systematic review. Eur J Surg Oncol. 2015;41(8):975–85.

    Article  CAS  PubMed  Google Scholar 

  93. Graves S, Seagle B, Strohl A, Shahabi S, Nieves-Neira W. Survival after pelvic exenteration for cervical cancer: a National Cancer Database study. Int J Gynecol Cancer. 2017;27(2):390–5.

    Article  PubMed  Google Scholar 

  94. Lopes T, Spirtos N, Naik R, Monaghan J. Exenterative surgery. In: Bonney’s gynaecological surgery: Wiley-Blackwell; 2010. p. 222–30.

    Google Scholar 

  95. Monaghan J. Central recurrent cervical cancer. In: An atlas of gynecologic oncology: CRC Press; 2011. p. 105–11.

    Google Scholar 

  96. Marnitz S, Dowdy S, Lanowska M, Schneider A, Podratz K, Kohler C. Exenterations 60 years after first description: results of a survey among US and German gynecologic oncology centers. Int J Gynecol Cancer. 2009;19(5):974–7.

    Article  PubMed  Google Scholar 

  97. Marnitz S, Kohler C, Muller M, Behrens K, Hasenbein K, Schneider A. Indications for primary and secondary exenterations in patients with cervical cancer. Gynecol Oncol. 2006;103(3):1023–30.

    Article  PubMed  Google Scholar 

  98. Yoo H, Lim M, Seo S, Kang S, Yoo C, Kim J, et al. Pelvic exenteration for recurrent cervical cancer: ten-year experience at National Cancer Center in Korea. J Gynecol Oncol. 2012;23(4):242–50.

    Article  PubMed  PubMed Central  Google Scholar 

  99. Berek J, Howe C, Lagasse L, Hacker N. Pelvic exenteration for recurrent gynecologic malignancy: survival and morbidity analysis of the 45-year experience at UCLA. Gynecol Oncol. 2005;99(1):153–9.

    Article  PubMed  Google Scholar 

  100. Goldberg G, Sukumvanich P, Einstein M, Smith H, Anderson P, Fields A. Total pelvic exenteration: the Albert Einstein College of Medicine/Montefiore Medical Center Experience (1987 to 2003). Gynecol Oncol. 2006;101(2):261–8.

    Article  PubMed  Google Scholar 

  101. Chiantera V, Rossi M, De Iaco P, Koehler C, Marnitz S, Fagotti A, et al. Morbidity after pelvic exenteration for gynecological malignancies: a retrospective multicentric study of 230 patients. Int J Gynecol Cancer. 2014;24(1):156–64.

    Article  PubMed  Google Scholar 

  102. Ungar L, Palfalvi L, Novak Z. Primary pelvic exenteration in cervical cancer patients. Gynecol Oncol. 2008;111(2 Suppl):S9–12.

    Article  PubMed  Google Scholar 

  103. Ang C, Bryant A, Barton D, Pomel C, Naik R. Exenterative surgery for recurrent gynaecological malignancies. Cochrane Database Syst Rev 2014(2):Cd010449.

    Google Scholar 

  104. Guimaraes G, Baiocchi G, Ferreira F, Kumagai L, Fallopa C, Aguiar S, et al. Palliative pelvic exenteration for patients with gynecological malignancies. Arch Gynecol Obstet. 2011;283(5):1107–12.

    Article  PubMed  Google Scholar 

  105. Magrina J, Stanhope C, Weaver A. Pelvic exenterations: supralevator, infralevator, and with vulvectomy. Gynecol Oncol. 1997;64(1):130–5.

    Article  CAS  PubMed  Google Scholar 

  106. Katory M, McLean R, Paez E, Kucukmetin A, Naik R. Short- and long-term outcomes following pelvic exenteration for gynae-oncological and colorectal cancers: a 9 year consecutive single-centre cohort study. Int J Surg. 2017;43:38–45.

    Article  PubMed  Google Scholar 

  107. Witjes A, Lebret T, Comperat E, Cowan N, De Santis M, Bruins H, et al. Updated 2016 EAU guidelines on muscle-invasive and metastatic bladder cancer. Eur Urol. 2017;71(3):462–75.

    Article  Google Scholar 

  108. Lee R, Abol-Enein H, Artibani W, Bochner B, Dalbagni G, Daneshmand S, et al. Urinary diversion after radical cystectomy for bladder cancer: options, patient selection, and outcomes. BJU Int. 2014;113(1):11–23.

    Article  PubMed  Google Scholar 

  109. Shah N, Ward K, Plaxe S, Saenz C, McHale M. Urinary diversions: a time to enrich surgical training? Gynecol Oncol. 2016;140(1):120–3.

    Article  PubMed  Google Scholar 

  110. Colombo R, Naspro R. Ileal conduit as the standard for urinary diversion after radical cystectomy for bladder cancer. Eur Urol Suppl. 2010;9(10):736–44.

    Article  Google Scholar 

  111. Davis N, Burke J, McDermott T, Flynn R, Manecksha R, Thornhill J. Bricker versus Wallace anastomosis: a meta-analysis of ureteroenteric stricture rates after ileal conduit urinary diversion. Can Urol Assoc J. 2015;9(5–6):E284–90.

    Article  PubMed  PubMed Central  Google Scholar 

  112. Bricker E. Bladder substitution after pelvic evisceration. Surg Clin North Am. 1950;30(5):1511–21.

    Article  CAS  PubMed  Google Scholar 

  113. Wallace D. Ureteric diversion using a conduit: a simplified technique. Br J Urol. 1966;38(5):522–7.

    Article  CAS  PubMed  Google Scholar 

  114. Wallace D. Uretero-ileostomy. Br J Urol. 1970;42(5):529–34.

    Article  CAS  PubMed  Google Scholar 

  115. Miller B, Morris M, Gershenson D, Levenback C, Burke T. Intestinal fistulae formation following pelvic exenteration: a review of the University of Texas M. D. Anderson Cancer Center experience, 1957–1990. Gynecol Oncol. 1995;56(2):207–10.

    Article  CAS  PubMed  Google Scholar 

  116. Musters G, Bemelman W, Bosker R, Burger J, van Duijvendijk P, van Etten B, et al. Randomized controlled multicentre study comparing biological mesh closure of the pelvic floor with primary perineal wound closure after extralevator abdominoperineal resection for rectal cancer (BIOPEX-study). BMC Surg. 2014;14:58.

    Article  PubMed  PubMed Central  Google Scholar 

  117. Morley G, Hopkins M, Lindenauer S, Roberts J. Pelvic exenteration, University of Michigan: 100 patients at 5 years. Obstet Gynecol. 1989;74(6):934–43.

    CAS  PubMed  Google Scholar 

  118. Turns D. Psychosocial issues: pelvic exenterative surgery. J Surg Oncol. 2001;76(3):224–36.

    Article  CAS  PubMed  Google Scholar 

  119. Wang C, Lai C, Huang H, Hong J, Chou H, Huang K, et al. Recurrent cervical carcinoma after primary radical surgery. Am J Obstet Gynecol. 1999;181(3):518–24.

    Article  CAS  PubMed  Google Scholar 

  120. Shingleton H, Soong S, Gelder M, Hatch K, Baker V, Austin J Jr. Clinical and histopathologic factors predicting recurrence and survival after pelvic exenteration for cancer of the cervix. Obstet Gynecol. 1989;73(6):1027–34.

    CAS  PubMed  Google Scholar 

  121. Benn T, Brooks R, Zhang Q, Powell M, Thaker P, Mutch D, et al. Pelvic exenteration in gynecologic oncology: a single institution study over 20 years. Gynecol Oncol. 2011;122(1):14–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  122. Höckel M. Laterally extended endopelvic resection: surgical treatment of infrailiac pelvic wall recurrences of gynecologic malignancies. Am J Obstet Gynecol. 1999;180(2 Pt 1):306–12.

    Article  PubMed  Google Scholar 

  123. Höckel M. Laterally extended endopelvic resection. Novel surgical treatment of locally recurrent cervical carcinoma involving the pelvic side wall. Gynecol Oncol. 2003;91(2):369–77.

    Article  PubMed  Google Scholar 

  124. Höckel M. Laterally extended endopelvic resection (LEER) – principles and practice. Gynecol Oncol. 2008;111(Suppl 2):S13–7.

    Article  PubMed  Google Scholar 

  125. Höckel M, Hentschel B, Horn L. Association between developmental steps in the organogenesis of the uterine cervix and locoregional progression of cervical cancer: a prospective clinicopathological analysis. Lancet Oncol. 2014;15(4):445–56.

    Article  PubMed  Google Scholar 

  126. Höckel M. Laterally extended endopelvic resection. In: An atlas of gynecologic oncology: CRC Press; 2011. p. 120–6.

    Google Scholar 

  127. Höckel M, Wolf B, Hentschel B, Horn L. Surgical treatment and histopathological assessment of advanced cervicovaginal carcinoma: a prospective study and retrospective analysis. Eur J Cancer. 2017;70:99–110.

    Article  PubMed  Google Scholar 

  128. Höckel M, Horn L, Einenkel J. (Laterally) extended endopelvic resection: surgical treatment of locally advanced and recurrent cancer of the uterine cervix and vagina based on ontogenetic anatomy. Gynecol Oncol. 2012;127(2):297–302.

    Article  PubMed  Google Scholar 

  129. Höckel M. Long-term experience with (laterally) extended endopelvic resection (LEER) in relapsed pelvic malignancies. Curr Oncol Rep. 2015;17(3):435.

    Article  PubMed  Google Scholar 

  130. Höckel M, Sclenger K, Hamm H, Knapstein P, Hohenfellner R, Rosler H. Five-year experience with combined operative and radiotherapeutic treatment of recurrent gynecologic tumors infiltrating the pelvic wall. Cancer. 1996;77(9):1918–33.

    Article  PubMed  Google Scholar 

  131. Höckel M, Knapstein P. The combined operative and radiotherapeutic treatment (CORT) of recurrent tumors infiltrating the pelvic wall: first experience with 18 patients. Gynecol Oncol. 1992;46(1):20–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, University of Patras, Rion, Achaia, Greece

    Georgios Androutsopoulos

  2. Department of Gynaecology, Northern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Gateshead, UK

    Raj Naik

Authors
  1. Georgios Androutsopoulos
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Raj Naik
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Georgios Androutsopoulos .

Editor information

Editors and Affiliations

  1. The Joan and Sanford I. Weill Medical College/Graduate School of Medical Sciences, The New York Presbyterian Hospital-Weill Cornell Medical Center, and Sandra and Edward Meyer Cancer Center, Cornell University, New York, NY, USA

    Samir A. Farghaly

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Androutsopoulos, G., Naik, R. (2019). Standard and Novel Surgical Treatment in Cervical Cancer. In: Farghaly, S. (eds) Uterine Cervical Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-02701-8_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-02701-8_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-02700-1

  • Online ISBN: 978-3-030-02701-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation