Evolving Trends in the Surgical Therapy of Patients with Gynecological Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 20 December 2024 | Viewed by 748

Special Issue Editor


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Guest Editor
Department of Gynecologic Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
Interests: gynecologic oncology; clinical studies on vulvar and cervical cancer

Special Issue Information

Dear Colleagues,

We are pleased to invite you to contribute to this Special Issue of Cancers in honor of Prof. Dr Neville F. Hacker. This Special Issue will focus on the trends in the surgical treatment of gynecological cancers. Over the last four decades, surgery has evolved from a one-size-fits-all treatment towards a more individualized treatment. In cervix and vulvar cancer, this individualized treatment is, in general, characterized by less radical procedures for selected groups of patients and greater focus on chemotherapy and/or radiotherapy for prognostically unfavorable groups of patients. An example of this is the treatment of cervix cancer clinically confined to the cervix (stage I). While in the past all patients with a clinical stage of I (IA2/IB) were treated with a type-C1,2 radical hysterectomy, current patients with a tumor diameter < 2 cm and negative pelvic nodes are treated with a simple hysterectomy. With the introduction of minimally invasive surgery and the sentinel node technique, even more individualized treatment is the result. In advanced ovarian cancer, the timing of debulking surgery has been a subject of debate over the last two decades. What are the selection criteria that can be used to make the decision to recommend either a primary or interval debulking surgery in an individual patient? This Special Issue aims to obtain a better insight into the evidence for the oncological safety and level of evidence for the efficacy of the trend towards the more individualized (surgical) treatment of gynecological cancers. 

In this Special Issue, original research articles and reviews on the topic of surgery in gynecological cancers are welcome. For example, research areas may include (but are definitely not limited to) the following:

  1. Surgery or primary chemo-radiotherapy for early cervix cancer and how to select patients.
  2. Is nerve-sparing radical hysterectomy a safe procedure?
  3. Adjuvant radiotherapy or re-excision in patients with an irradical resection margin after surgical treatment for vulvar cancer.
  4. Primary debulking or interval debulking in stage III/IV ovarian cancer. Pros and cons and how to select patients.
  5. Is the debulking of a stage III ovarian cancer through minimally invasive surgery a safe procedure?

We look forward to receiving your contributions.

Dr. Jacobus van der Velden
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • endometrial cancer
  • ovarian cancer
  • vulvar cancer
  • cervix cancer
  • resection margin
  • bulky lymph node
  • parametrectomy
  • debulking
  • preservation ovary
  • minimally invasive surgery

Published Papers (1 paper)

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Research

11 pages, 1194 KiB  
Article
Patterns of First Recurrence and Oncological Outcomes in Locally Advanced Cervical Cancer Patients: Does Surgical Staging Play a Role?
by Vicente Bebia, Berta Díaz-Feijoo, Álvaro Tejerizo, Aureli Torne, Virginia Benito, Alicia Hernández, Mikel Gorostidi, Santiago Domingo, Melissa Bradbury, Rocío Luna-Guibourg and Antonio Gil-Moreno
Cancers 2024, 16(7), 1423; https://doi.org/10.3390/cancers16071423 - 06 Apr 2024
Viewed by 535
Abstract
Background: We aimed to determine whether surgical aortic staging by minimally invasive paraaortic lymphadenectomy (PALND) affects the pattern of first recurrence and survival in treated locally advanced cervical cancer (LACC) patients when compared to patients staged by imaging (noPALND). Methods: This study was [...] Read more.
Background: We aimed to determine whether surgical aortic staging by minimally invasive paraaortic lymphadenectomy (PALND) affects the pattern of first recurrence and survival in treated locally advanced cervical cancer (LACC) patients when compared to patients staged by imaging (noPALND). Methods: This study was a multicenter observational retrospective cohort study of patients with LACC treated at tertiary care hospitals throughout Spain. The inclusion criteria were histological diagnosis of squamous carcinoma, adenosquamous carcinoma, and/or adenocarcinoma; FIGO stages IB2, IIA2-IVA (FIGO 2009); and planned treatment with primary chemoradiotherapy between 2000 and 2016. Propensity score matching (PSM) was performed before the analysis. Results: After PSM and sample replacement, 1092 patients were included for analysis (noPALND n = 546, PALND n = 546). Twenty-one percent of patients recurred during follow-up, with the PALND group having almost double the recurrences of the noPALND group (noPALND: 15.0%, PALND: 28.0%, p < 0.001). Nodal (regional) recurrences were more frequently observed in PALND patients (noPALND:2.4%, PALND: 11.2%, p < 0.001). Among those who recurred regionally, 57.1% recurred at the pelvic nodes, 37.1% recurred at the aortic nodes, and 5.7% recurred simultaneously at both the pelvic and aortic nodes. Patients who underwent a staging PALND were more frequently diagnosed with a distant recurrence (noPALND: 7.0%, PALND: 15.6%, p < 0.001). PALND patients presented poorer overall, cancer-specific, and disease-free survival when compared to patients in the noPALND group. Conclusion: After treatment, surgically staged patients with LACC recurred more frequently and showed worse survival rates. Full article
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