Oncologic Surgical Approaches in Cervical Cancer
Summary
Cervical cancer remains a significant global health concern, particularly in low- and middle-income regions. Surgical management spans a spectrum from standard radical hysterectomy with pelvic lymphadenectomy to fertility-preserving procedures and advanced minimally invasive techniques. Open radical hysterectomy has long been the cornerstone for early-stage disease, offering established oncological safety. Laparoscopic and robotic-assisted approaches have gained traction owing to reduced blood loss, shorter hospital stay and quicker recovery, although their long-term oncological equivalence continues to be evaluated. Sentinel lymph node mapping refines nodal assessment by targeting the first echelon nodes, while laparoscopic para-aortic staging informs radiotherapy planning in locally advanced cases. For women wishing to retain fertility, radical trachelectomy and cervical conization with lymph node evaluation show promising oncologic and obstetrical outcomes in carefully selected patients. Advances in imaging, intraoperative guidance and multidisciplinary risk stratification underpin a personalised surgical strategy that balances disease control with quality of life.
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Oncologic Surgical Approaches in Cervical Cancer publication trend
The graph below shows the total number of articles in oncologic surgical approaches in cervical cancer across all publications each year (not limited to Nature Index journals).
Technical terms
Radical hysterectomy: Surgical removal of the uterus, cervix, upper vagina and surrounding parametrial tissue for oncological control.
Laparoscopic radical hysterectomy (LRH): Minimally invasive procedure employing small incisions and a camera to perform a radical hysterectomy.
Sentinel lymph node mapping: Technique to identify and biopsy the first lymph nodes draining the tumour to guide selective lymphadenectomy.
Radical trachelectomy: Fertility-preserving surgery that excises the cervix and upper vagina while retaining the uterine corpus, combined with pelvic lymph node assessment.
References
- Laparoscopy versus laparotomy for the management of early stage cervical cancer. BMC Cancer (2015).
- ESGO/ESTRO/ESP Guidelines for the management of patients with cervical cancer – Update 2023*. International Journal of Gynecological Cancer (2023).
- Prospective Multicenter Study Evaluating the Survival of Patients With Locally Advanced Cervical Cancer Undergoing Laparoscopic Para-Aortic Lymphadenectomy Before Chemoradiotherapy in the Era of Positron Emission Tomography Imaging. Journal of Clinical Oncology (2013).
- A Comparison of Radiocolloid and Indocyanine Green Fluorescence Imaging, Sentinel Lymph Node Mapping in Patients with Cervical Cancer Undergoing Laparoscopic Surgery. Annals of Surgical Oncology (2015).
- Oncologic and obstetrical outcomes with fertility-sparing treatment of cervical cancer: a systematic review and meta-analysis. Oncotarget (2017).
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