Didactics-Management of Cervical Cancer

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In the management of cervical cancer less than two centimeters, tumor size is an important factor in staging. For early and locally advanced cancer, different types of hysterectomy are performed based on the stage. However, for tumors less than two centimeters, there is low risk of recurrence or death from the disease. Retrospective data show that the risk of parametrial invasion is less than 1% in this low-risk group, and lymph node metastasis is also low. Several studies have shown the feasibility and safety of less radical surgery in this patient population, including simple hysterectomy or preservation of fertility. The SHAPE trial has compared simple hysterectomy to radical hysterectomy and found that simple hysterectomy is not inferior in terms of recurrence rates at three years. There are still some ongoing issues, such as the applicability of the results to HPV-independent adenocarcinoma, the use of MRI for patient selection, concerns about the safety of minimally invasive surgeries, and the impact of con on outcomes. Overall, evaluating tumor size and depth of invasion is crucial in deciding the appropriate surgical approach for early-stage cervical cancer.

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Yoo-Young Lee
December 2023

Keywords

cervical cancer

tumor size

hysterectomy

recurrence rates

surgical approach