Gynecologic oncology and pathologyAdvances in the surgical management of invasive cervical cancerMorice, Philippe; Castaigne, DamienneAuthor Information Institut Gustave-Roussy, Villejuif, France Correspondence to Philippe Morice, Service de Chirurgie Gynécologique, Institut Gustave-Roussy, 39 rue Camille-Desmoulins, 94805 Villejuif Cedex, France Tel: +33 1 42 11 44 31; fax: +33 1 42 11 52 13; e-mail: [email protected] Current Opinion in Obstetrics and Gynecology: February 2005 - Volume 17 - Issue 1 - p 5-12 Buy SDC Abstract Purpose of review Cervical cancer is the second most frequent cancer in women in the world. Surgery plays a major role, particularly in patients with early-stage disease. This review focuses on the evaluation of important papers published since January 2003 on the management of invasive cervical cancer. Recent findings Patients are classified as having early-stage (stage IB1) or advanced-stage (stage IB2 or greater) disease. Several papers are devoted to the evaluation of prognostic factors in patients with early-stage disease and negative nodes. Several recurrences after radical trachelectomy have been reported that remind us that strict selection criteria are mandatory for conservative management. The development of sentinel node and laparoscopic procedures has gained momentum. For patients with advanced-stage disease, the place of staging procedures in para-aortic areas or pelvic surgery after chemoradiation therapy continues to be debated and is currently being investigated in randomized studies. Several papers also continue to debate surgical treatment modalities for recurrent disease (the place of laparoscopy and reconstructive surgery). Summary Several interesting papers have been published since 2003 about the surgical treatment of cervical cancer. Laparoscopic surgery and the sentinel node procedure have developed considerably, particularly for the surgical management of early-stage disease. The results of ongoing studies are awaited to determine the value of pelvic surgery (after neoadjuvant treatment) in patients with advanced-stage disease. Abbreviations CRT: chemoradiation therapy; FIGO: Federation of Gynecology and Obstetrics; FSA: frozen section analysis; GOG: Gynecologic Oncology Group; LAPRH: laparoscopic pure radical hysterectomy; LAVRH: laparoscopicovaginal radical hysterectomy; LCRA: low-colorectal anastomosis; LVS: lymphovascular space; NCT: neoadjuvant chemotherapy; PE: pelvic exenteration; RT: radical trachelectomy; SNP: sentinel node procedure. Copyright © 2005 YEAR Wolters Kluwer Health, Inc. All rights reserved.