PDF(Pubmed)
Abstract：
Cervical cancer represents a global health issue as it is mostly encountered in women of reproductive age, while at the same time, survival outcomes seem to have remained constant during the last two decades. The need to implement fertility-sparing strategies as well as to decrease the morbidity that accompanies radical treatment has been extensively studied. During the last decade, several randomized clinical trials have been released, resulting in significant advances in the surgical treatment of early-stage disease. At the same time, evidence about the surgical treatment of advanced-stage disease as well as recurrent disease has gradually appeared and seems to be promising, thus leading the point forward towards personalized medicine that will remove the surgical barriers that seem concrete in our era. Nevertheless, the discrepancies in perioperative morbidity and survival outcomes that were observed among published studies raise several questions. In the present article, we chose to review the gray fields in the surgical treatment of early-stage and advanced-stage cervical cancer. Studies that are based on strong evidence that support current clinical practice are compared to smaller cohorts that present novel data that may form the basis for future research, and issues that remain poorly explored are discussed in an effort to help establish a consensus for future research development.
摘要：
宫颈癌是一个全球性的健康问题，因为它主要发生在育龄妇女身上。同时,在过去的二十年中，生存结果似乎一直保持不变。已广泛研究了实施保留生育力的策略以及降低伴随根治性治疗的发病率的必要性。在过去的十年里，已经发布了几项随机临床试验，在早期疾病的外科治疗方面取得了重大进展。同时,关于晚期疾病以及复发性疾病的手术治疗的证据已经逐渐出现，并且似乎是有希望的，从而引领了个性化医疗的发展，这将消除我们时代看似具体的手术障碍。然而，在已发表的研究中观察到的围手术期发病率和生存结局的差异引发了几个问题.在本文中,我们选择回顾早期和晚期宫颈癌手术治疗的灰色领域。基于支持当前临床实践的有力证据的研究与较小的队列进行比较，这些队列提供了可能构成未来研究基础的新数据。并讨论了仍未充分探索的问题，以帮助建立未来研究发展的共识。
