Primary surgical treatment of cervical cancer

Abstract

Surgery is still the standard treatment for early stage cervix cancer. This form of cancer generally implies the need for a radical hysterectomy with a bilateral pelvic lymphadenectomy (BPL). Patients who benefit from this procedure include those bearing tumors smaller than 4 cm that are confined to the cervix. The goal of these procedures is to resect the entire tumor and to establish, based on pathological analysis, whether the patient possesses pathological risk factors that support adjuvant radiotherapy and chemotherapy. However, surgical treatment is not exempt from complications, which have been reported during the intraoperative period in approximately 2% of cases and during the late postsurgical phase in up to 20%of cases. Over the decades, new minimally invasive methods have been implemented to decrease the appearance of these complications while yielding the same oncological results. Additionally, the sentinel lymph node biopsy in cervical cancer is beginning to be incorporated as an alternative to BPL. Moreover, new techniques that preserve fertility are now used in strictly selected young women who would like to have more children.