title: New classification system of radical hysterectomy: emphasis on a three-dimensional anatomic template for parametrial resection.
abstract: OBJECTIVE
  The international acceptance of a universal classification system for radical hysterectomy is one of the important challenges in gynecologic oncology. The recently published classification system by Querleu and Morrow is a relevant proposal that has been well received by the professional community. However, it does not include a description of parametrial resection in three dimensions, which mostly determines post-operative morbidity.
  
  
  METHODS
  The intention of this follow-up paper was to further develop the classification system based on the four proposed types of radical hysterectomy (A-D) into a three-dimensional model using standard anatomical landmarks for definition of resection margins in longitudinal and transverse dimensions and demonstrate it on pictures.
  
  
  RESULTS
  Resection margins were defined in longitudinal and transverse dimensions for each suggested type of radical hysterectomy on all three parts of the parametria. Besides precise description using stable anatomical landmarks, all resection lines have been shown on intra-operative photographs.
  
  
  CONCLUSIONS
  Four types of radical hysteretomy can be precisely defined on a three-dimensional anatomical template, including nerve sparing procedure. Our paper should contribute to better standardization (including nomenclature) of the radical hysterectomy, enhancing harmonization of clinical practice in gynecological oncology.
authors: Gynecologic Oncology Centre, Department of Obstetrics and Gynaecology, General University Hospital, First Medical School, Charles University, Prague, Czech Republic. david.cibula@iol.cz
authors: D
authors: D
authors: Cibula
authors: N R
authors: NR
authors: Abu-Rustum
authors: P
authors: P
authors: Benedetti-Panici
authors: C
authors: C
authors: Köhler
authors: F
authors: F
authors: Raspagliesi
authors: D
authors: D
authors: Querleu
authors: C P
authors: CP
authors: Morrow