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早期宫颈癌治疗——有哪些新进展?

Early-stage cervical cancer treatment - what's new?

作者信息

Dio Camilla Di, Azenkoud Ilham, Trezza Angelo, Lentini Emanuele, D'Augè Tullio Golia, Cuccu Ilaria, Bartolomeo Giorgia Di, Firulli Ilaria, Canicchio Andrea, Sgamba Ludovica, Muzii Ludovico

机构信息

Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.

出版信息

Prz Menopauzalny. 2023 Jun;22(2):87-92. doi: 10.5114/pm.2023.127774. Epub 2023 Jun 2.

Abstract

The gold standard of treatment for patients with early-stage cervical cancer is radical hysterectomy, in agreement with the entire scientific community. During the last decade, growing evidence has supported the minimally invasive approach. Several studies have suggested that the minimally invasive approach could improve surgical and perioperative outcomes. Because of these findings, ESCO/ESTRO/ESP guidelines state that a "minimally invasive approach is favoured" in comparison with open surgery, as a grade B recommendation. Because of the lack of a grade A recommendation, this randomized Laparoscopic Approach to Cervical Cancer trial evaluated open vs. minimally invasive approach in the early stage. It demonstrated an increase in mortality among patients treated with minimally invasive surgery, revolutionizing current thinking on the primary surgical approach to early cervical cancer. The aim of this study is to analyse which is the best treatment for early cervical cancer and which approach is the most effective at the moment. Further studies are needed to state with certainty the appropriateness of the treatments offered to patients with early cervical cancer.

摘要

早期宫颈癌患者的治疗金标准是根治性子宫切除术,这一点得到了整个科学界的认同。在过去十年中,越来越多的证据支持微创方法。多项研究表明,微创方法可改善手术及围手术期结果。基于这些发现,欧洲妇科内镜学会(ESCO)/欧洲放射肿瘤学会(ESTRO)/西班牙妇科肿瘤学会(ESP)指南指出,与开放手术相比,“微创方法更受青睐”,这是一项B级推荐。由于缺乏A级推荐,这项宫颈癌腹腔镜治疗随机试验评估了早期宫颈癌的开放手术与微创方法。该试验表明,接受微创手术治疗的患者死亡率有所上升,这彻底改变了目前对于早期宫颈癌主要手术方法的看法。本研究的目的是分析早期宫颈癌的最佳治疗方法以及目前哪种方法最有效。需要进一步研究以确定为早期宫颈癌患者提供的治疗方法是否恰当。

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