PERSPECTIVES FOR SURGICAL GYNECOLOGY IN T HE TREATMENT OF CERVICAL-CANCER

Both the gain of new tumor biological insights, particularly the relev ance of tumor oxygenation and vascularity in addition to tumor volume for disease progression and resistance towards therapy, and the develo pment of novel ablative and reconstructive pelvic surgical techniques may lead to a paradigm shift in the treatment of cancer of the uterine cervix. With respect to stage, size, and predicted tumor biological f eatures, either less radical or extended radical surgical treatment sh ould be investigated in clinical trials with standard therapy (abdomin al radical hysterectomy and pelvic/periaortic lymph node dissection fo r early-stage disease and percutaneous/intracavitary radiation for loc ally advanced disease) as control. Improving the therapeutic index and increasing the therapeutic window in cervical cancer appear to be an exciting challenge for surgical gynecology in the future.