Zigras Tiffany, Lennox Genevieve, Willows Karla, Covens Allan
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Toronto, M700-610 University Avenue, Toronto, ON, M5G 2M9, Canada.
Division of Gynecologic Oncology, T2051 Odette Cancer Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
Curr Oncol Rep. 2017 Aug;19(8):51. doi: 10.1007/s11912-017-0614-5.
Advances in cervical cancer screening and treatment have resulted in high cure rates in developed countries for early-stage disease. Current research focuses on minimizing morbidity and maximizing quality of life.
Imaging has been disappointing in identifying small volume metastases. Sentinel lymph node biopsy represents a significant advantage with high sensitivity, low false negative rates, reduced morbidity, and equivalent survival in recent studies compared to pelvic lymphadenectomy. Non-radical surgical options are currently being investigated for early cervical cancer in a number of large prospective studies in patients at low risk for metastases. Evidence suggests that sentinel lymph node biopsy and non-radical surgery are safe approaches for the staging and management of early cervical cancer in appropriately selected patients with the potential to significantly reduce treatment-related morbidity.
宫颈癌筛查和治疗方面的进展已使发达国家早期疾病的治愈率很高。当前研究聚焦于将发病率降至最低并使生活质量最大化。
影像学在识别小体积转移灶方面效果不佳。前哨淋巴结活检具有显著优势,在近期研究中与盆腔淋巴结清扫术相比,其灵敏度高、假阴性率低、发病率降低且生存率相当。目前,多项针对转移风险低的患者的大型前瞻性研究正在探究早期宫颈癌的非根治性手术选择。有证据表明,对于经过适当选择的患者,前哨淋巴结活检和非根治性手术是早期宫颈癌分期和管理的安全方法,有可能显著降低治疗相关的发病率。