[Role of laparoscopy in the management of uterine cervix cancer].
At the turn of this century, the evidence of the benefits of a concurrent chemo-radiotherapy in locally advanced tumors and the development of mini-invasive surgery (laparoscopic and radical vaginal surgery) are the two main advances in the management of cervical carcinomas. From a personal experience of 304 cervical carcinomas, the different techniques of laparoscopy used in cervical carcinomas are addressed and discussed. Their long-term results when involved in the management protocols of cervical carcinomas at different stages are reported. From this series, some conclusions are drawn: 1) laparoscopy can spare a laparotomy in early-stage node-negative patients with low tumoral volume; 2) it can spare a systematic extended-field radiation therapy in high-risk patients with node-negative para-aortic exploration; 3) it can spare surgery in patients with a centro-pelvic advanced stage or recurrence, possibly candidates for an exenterative procedure, if occult spread is found in the intra- or retroperitoneal areas. The more and more frequent combination of the mini-invasive surgery for staging and treatment and radiotherapy or chemotherapy explains the need for new protocols of a more and more complex and specialized management.
Leblanc
E
E
Département de sénologie et cancérologie gynécologique, centre Oscar-Lambret, Lille, France.
Querleu
D
D
Castelain
B
B
Occelli
B
B
Chauvet
M P
MP
Chevalier
A
A
Lesoin
A
A
Vilain
M O
MO
Taieb
S
S
D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018196:Carcinoma, Adenosquamous / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy; D008197:Lymph Node Excision; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D010053:Ovary / Q000601:surgery; D011336:Probability; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D016019:Survival Analysis; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*
D000970:Antineoplastic Agents; D002945:Cisplatin