Standardization and experience may influence the survival of laparoscopic radical hysterectomy for cervical cancer

The Impaction of Laparoscopic versus Laparotomy for Lymphovascular Space Invasion of Early Cervical Cancer

“…We assumed that the use of uterine manipulator, the circulating pneumoperitoneum CO 2 gas and the disturbance of the superficial mesothelial layer caused through the high CO2 pressure, and the compression of tumor tissue during LRH may further disrupt the tumor and lead to the dissemination of tumor cell into the surrounding vessels and lymphatics, which more likely to cause LVSI. [ 5 6 27 28 ] However, adequate number of tumor cell required to establish the metastasis. [ 29 ] Our research found that, when we compared the conditions with postoperative LVSI, it was higher significantly LRH than ARH.…”

“…The result may be associated with the uterine manipulator squeezing of the uterine cervix, intraperitoneal colpotomy in laparoscopic, and CO2 set up an acid environment, which can lead to tumor cell spillage, shedding, and dissemination. [ 4 5 6 ]…”

From Radical Hysterectomy to Radical Surgery for Deep Endometriosis

“…On the contrary, our hospital data, Lee–Huang team's published article “standardization and experience may influence the survival of LRH for cervical cancer” showed a 100% from 5-year survival of patients with cervical cancer operated with MIS approach from 2009 to 2014. [ 15 ] Extrapolate from our data, with standardization of surgical techniques and surgeons' experience, should improve treatment outcomes [ Figure 1 ].…”

Neurogenic bladder in patients with cervical cancer after treatment

“…Cervical cancer is still a global health burden worldwide, contributing to the fourth most common cancer in women in the world and a leading cause of cancer death of women in developing countries, although cervical cancer rates are dramatically decreasing overall among women in the United States, and Taiwan after an application of precancer screening strategies. [1][2][3][4][5] Despite of which cancer subtype and human papilloma virus (HPV) infection status, primary treatment with curative intent for women with cervical cancer consists of surgery (radical hysterectomy [RH] or radical trachelectomy), concurrent chemoradiation (CCRT), or a pretreatment therapy (neoadjuvant chemotherapy [NACT]) and a combination of these treatments; and in routine clinical practice, the treatment opinion is often based on the International Federation of Obstetrics and Gynecology (FIGO) cancer stage and sometimes according to the fertility consideration. 1,2,6 However, the complications of treatment either by surgery or by CCRT have persistent negative impacts on the physiological and psychological function of women.…”

“…11 One critical and important issue about the QoL and oncology safety of women with cervical cancer after the use of modified approach based on less in place of the conventional exploratory or abdominal RH, such as minimally invasive surgery (laparoscopic and robotic approach) and nerve-sparing RH is still arguable and consensus is not in agreement for all gynecological oncologists. 1,4,5,9 Although the trend in use of less invasive procedures, including simple hysterectomy and the aforementioned modified approach for the management of early-stage cervical cancer may be increased, 12 much concern is present whether the "radicality (extent) of surgery" is adequate. 12,13 Dr. Sia used the National Cancer Database to review the case of women with FIGO stage IA2 and IB1 (<2 cm) cervical cancer between 2004 and 2015 and they found although simple hyster4ectomy did not influence the 5-year survival outcome for FIGO stage IA1 cancer (95.1% for RH and 97.6% for simple hysterectomy with HR of 0.70, 95% CI 0.41-1.20), 5-year survival was significantly better in women with FIGO IB1 treated with RH compared to that with simple hysterectomy (95.3% versus 92.4% with HR 1.55, 95% CI 1.18-2.03), suggesting the parametrial resection (parametrectomy) during hysterectomy (RH) is a critical procedure as the treatment of choice for women with FIGO stage IB1 cervical cancer.…”