Royal Marsden Hospital, London, SW3 6JA, UK; St George's University of London, Cranmer Terrace, Tooting, London SW17 0RE, UK.
Best Pract Res Clin Obstet Gynaecol. 2021 Sep;75:2-9. doi: 10.1016/j.bpobgyn.2021.04.004. Epub 2021 May 6.
Until the late 1980s, the mainstay of treatment for cervical cancer has been either hysterectomy or radiotherapy. From the mid to late 1990s, surgical treatments have been focussed more on sparing fertility by preserving the corpus of the womb with trachelectomy or even conserving part of the cervical stroma with a cone biopsy. In carefully selected cases, less radical treatment that preserves the uterus has been considered safe. However, these approaches can be associated with specific operative and obstetric complications such as stitch ulceration, cervical stenosis, late miscarriage, and premature labour. Most guidelines agree that the management of such patients should be centralised in a unit with specialist gynaecological oncology, radiology, and histopathology services supported by specialist cancer nurses.
直到 20 世纪 80 年代末,宫颈癌的主要治疗方法一直是子宫切除术或放疗。从 20 世纪 90 年代中期到后期,手术治疗的重点更多地放在通过保留子宫体的子宫颈管切除术或甚至通过子宫颈锥切术保留部分宫颈基质来保留生育能力上。在精心挑选的病例中,保留子宫的非根治性治疗被认为是安全的。然而,这些方法可能会导致特定的手术和产科并发症,如缝线溃疡、宫颈狭窄、晚期流产和早产。大多数指南都认为,此类患者的管理应该集中在一个有妇科肿瘤学、放射学和组织病理学专业服务的单位,由专业的癌症护士提供支持。