SURGERY FOR MALIGNANT GYNECOLOGIC DISEASE

The surgical management of malignant gynecologic disease continues to evolve as more is learned about the natural history and biology of the se neoplasms. Whereas curing malignancies remains the ultimate goal of most surgical procedures for gynecologic cancers, the importance of q uality of life cannot be ignored. Surgical procedures that enhance the quality of life without compromising cure continue to be explored. In vulvar cancer, the disfiguring classical radical vulvectomy is being replaced by more conservative procedures. As anesthetic techniques and postoperative care continue to improve, the role of radical surgery f or invasive and recurrent cervical cancer has been extended to include older women. Ovarian cancer continues to be the most lethal of all gy necologic malignancies, and the role of aggressive primary and seconda ry cytoreduction continues to be defined. The new International Federa tion of Gynecology and Obstetrics staging system for endometrial cance r has generated controversy regarding the benefits and morbidity assoc iated with surgical staging.