Department of Gynecologic Oncology, National Cancer Institute G. Pascale, Via Mariano Semmola, 80131, Naples, Italy.
Curr Oncol Rep. 2012 Dec;14(6):527-34. doi: 10.1007/s11912-012-0269-1.
Early cervical cancer, in particular in the presence of favorable pathologic risk factors, accounts for a very low incidence of parametrial involvement and lymph node metastasis. This means that a less radical surgery may be an oncologically safe treatment in selected cases, with the aim of preserving fertility and/or reducing morbidity without compromising survival. The extensiveness of surgery has decreased relatively in recent decades, the "modified" radical hysterectomy still being the current gold standard by most international guidelines. Vaginal (or abdominal) radical trachelectomy, simple hysterectomy, or cervical conization has been proposed in association with pelvic lymphadenectomy. Sentinel lymph node mapping may be an option to avoid a complete pelvic lymphadenectomy. Ongoing research efforts are especially being made in properly identifying the patient subset suitable for a conservative/less radical approach and prospectively confirming the oncological safety of the proposed clinical-pathological algorithms.
早期宫颈癌，尤其是在存在有利的病理危险因素的情况下，发生宫旁浸润和淋巴结转移的概率非常低。这意味着在某些特定情况下，一种不太激进的手术可能是一种肿瘤学上安全的治疗方法，目的是在不影响生存的情况下保留生育能力和/或降低发病率。手术的广泛性在最近几十年相对降低，“改良”根治性子宫切除术仍然是大多数国际指南的当前金标准。经阴道（或腹部）根治性子宫颈切除术、单纯子宫切除术或子宫颈锥切术已与盆腔淋巴结切除术联合提出。前哨淋巴结绘图术可能是避免完全盆腔淋巴结切除术的一种选择。目前正在进行的研究工作特别致力于正确识别适合保守/不太激进方法的患者亚组，并前瞻性地确认所提出的临床病理算法的肿瘤学安全性。
