Department of Obstetrics and Gynecology, University of Erlangen, Erlangen, Germany
Institute for Surgical Pathology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Anticancer Res. 2020 Jun;40(6):3049-3053. doi: 10.21873/anticanres.14285.
BACKGROUND/AIM: Recent studies have demonstrated the inferior overall survival outcomes of patients with early-stage cervical cancer who undergo minimally invasive surgery (MIS). One possible explanation for these unexpected results is intraoperative tumor manipulation.
Considering this hypothesis, we have reviewed the literature on the oncological outcomes of patients with villoglandular adenocarcinoma (VGA) of the cervix, an uncommon variant of cervical cancer that has an excellent prognosis.
VGA generally presents as an exophytic mass arising from the endocervix. In a systematic review, we identified 221 patients treated surgically for VGA (FIGO stage Ia-Ib). Of these, 11 developed recurrence, and four died. The recurrence sites in 8 cases were the pelvis (n=3), vaginal cuff (n=3), episiotomy scar (n=1), and cervix (n=1). Furthermore, 23 VGA-patients were treated by MIS, four experienced recurrence, and one died. Three intraabdominal metastases after MIS were reported.
Excessive tumor-handling during MIS or manipulations, e.g. cervix-dilation (during delivery), can worsen the otherwise excellent prognosis.
背景/目的：最近的研究表明，接受微创手术（MIS）的早期宫颈癌患者的总体生存结果较差。这些意外结果的一个可能解释是术中肿瘤操作。
考虑到这一假设，我们回顾了关于宫颈绒毛腺管状腺癌（VGA）患者的肿瘤学结果的文献，VGA 是一种罕见的宫颈癌变体，预后良好。
VGA 通常表现为从宫颈内口长出的外生性肿块。在系统评价中，我们确定了 221 例接受手术治疗的 VGA（FIGO 分期 Ia-Ib）患者。其中 11 例复发，4 例死亡。8 例复发部位为骨盆（n=3）、阴道袖口（n=3）、会阴切开疤痕（n=1）和宫颈（n=1）。此外，23 例 VGA 患者接受了 MIS 治疗，4 例复发，1 例死亡。报告了 MIS 后出现的 3 例腹腔转移。
MIS 期间过度的肿瘤处理或操作，例如宫颈扩张（在分娩期间），可能会使原本良好的预后恶化。
