Conservative surgical methods for FIGO stage IA2 squamous cervical carcinoma and their role in preserving women's fertility
Φόρτωση...
Ημερομηνία
Τίτλος Εφημερίδας
Περιοδικό ISSN
Τίτλος τόμου
Εκδότης
Περίληψη
Τύπος
Είδος δημοσίευσης σε συνέδριο
Είδος περιοδικού
peer-reviewed
Είδος εκπαιδευτικού υλικού
Όνομα συνεδρίου
Όνομα περιοδικού
Gynecol Oncol
Όνομα βιβλίου
Σειρά βιβλίου
Έκδοση βιβλίου
Συμπληρωματικός/δευτερεύων τίτλος
Περιγραφή
OBJECTIVE: Until recently, the treatment of choice for stage IA2 squamous cervical cancer has been radical hysterectomy with pelvic node dissection. However, many of these cases occur in younger women, for whom the preservation of fertility is desirable. More conservative methods have emerged as alternative treatment modalities for these women, as they may allow for future fertility, without having a considerable adverse effect on cure rates. The objective of this review is to present the published data on these methods (radical vaginal, abdominal or laparoscopic trachelectomy and laparoscopic pelvic lymphadenectomy, deep cold-knife excision and lymphadenectomy, ovarian transposition and radiotherapy) and comment on their clinical role. METHOD: A detailed literature search was done in MEDLINE (1966-2003), EMBASE (1974-2003) and CINAHL (1982-2003) for data on cure rates, survival and reproductive outcome of radical vaginal trachelectomy as well as other conservative treatment options. RESULTS: The recurrence rates after radical trachelectomy range from 0% to 8% and are comparable to reported results from series of patients treated with radical hysterectomy. There are over 35 reported live births out of approximately 210 women who had this operation. However, the rates of second trimester losses and preterm deliveries due to cervical weakness are high. Data from the other methods are limited. CONCLUSION: Vaginal radical trachelectomy is currently the fertility-sparing procedure with the most available data supporting its use. Although these results are encouraging, there is lack of level I evidence (i.e. randomized controlled trials) comparing safety and survival rates between conservative and radical methods. Therefore, these techniques should be used by fully trained operators, with the understanding that this is not the standard treatment at present.
Περιγραφή
Λέξεις-κλειδιά
Carcinoma, Squamous Cell/pathology/*surgery, Female, Fertility, Gynecologic Surgical Procedures/adverse effects/*methods, Humans, Laparoscopy/adverse effects/methods, Lymph Node Excision, Neoplasm Staging, Uterine Cervical Neoplasms/pathology/*surgery
Θεματική κατηγορία
Παραπομπή
Σύνδεσμος
http://www.ncbi.nlm.nih.gov/pubmed/15099964
http://ac.els-cdn.com/S0090825804001052/1-s2.0-S0090825804001052-main.pdf?_tid=062d8d7bea695e76d734425eb644693e&acdnat=1333714183_bbf6434c0b90d75f83cf64d7d80c87cc
http://ac.els-cdn.com/S0090825804001052/1-s2.0-S0090825804001052-main.pdf?_tid=062d8d7bea695e76d734425eb644693e&acdnat=1333714183_bbf6434c0b90d75f83cf64d7d80c87cc
Γλώσσα
en
Εκδίδον τμήμα/τομέας
Όνομα επιβλέποντος
Εξεταστική επιτροπή
Γενική Περιγραφή / Σχόλια
Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος
Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής