[New concepts for surgical therapy of cervical carcinoma].

Abdominal radical hysterectomy (Wertheim operation) is the current standard of surgical therapy of cervical carcinoma. It is based on historical concepts of female pelvic anatomy and locoregional tumor spread. This surgical therapy - depending on the individual radicality of the operation - leads to damage of essential structures not involved by the tumor, e.g. the autonomic pelvic nerves. Despite of its supposed radicality the Wertheim operation has to be combined with adjuvant radiotherapy in case of histopathological high risk factors to reach acceptable rates of tumor control. The total mesometrial resection (TMMR) uses new insights in pelvic anatomy and local tumor spread derived from developmental biology for a new concept of radicality achieving a high regional control rate with minimal treatment-related morbidity without adjuvant radiotherapy.