Pregledni rad

Basic principles in surgical treatment of gynecologic malignancies

Herman Haller ; Department of Gynecology and Obstetrics, Clinical Hospital Center Rijeka, Rijeka University School of Medicine, Rijeka, Croatia
Stanislav Rupčić ; Department of Gynecology and Obstetrics, Clinical Hospital Center Rijeka, Rijeka University School of Medicine, Rijeka, Croatia
Mirosalv Stamatović ; Department of Gynecology and Obstetrics, Clinical Hospital Center Rijeka, Rijeka University School of Medicine, Rijeka, Croatia
Ozren Mamula ; Department of Gynecology and Obstetrics, Clinical Hospital Center Rijeka, Rijeka University School of Medicine, Rijeka, Croatia
Jasna Gobić ; Department of Gynecology and Obstetrics, Clinical Hospital Center Rijeka, Rijeka University School of Medicine, Rijeka, Croatia

Sažetak

In the treatment of gynecologic malignancies surgery represents a cornerstone of gynecologic oncology. Surgery is important to establish the definitive diagnosis, to define the extent of disease and to eliminate the tumor according to the type and localization. The most frequent tumors among gynecologic malignancies are cervical, endometrial and ovarian cancer. Actual surgical approach in early cervical cancer with microscopic extension includes conservative techniques, in the first place the use of conisation. In the same group of patients but with fulfilled reproductive activities, hysterectomy is recommended. Radical surgery could be applied in invasive cervical cancer staged IB1 to IIA. Surgical treatment in the advanced stage of cervical cancer could be exerted exclusively in controlled trials as a part of multimodal treatment.
Endometrial cancer still remains incompletely defined in the extension of surgical procedures. Namely, lymphadenectomy in patients with endometrial cancer according to the low rate of lymphatic dissemination is not completely accepted in hospital daily practice. Furthermore, the increasing use of minimal invasive surgery transforms our way of thinking, especially in the case of endometrial cancer. Ovarian cancer still remains an unresolved diagnostic problem with negative implication in the treatment efficacy. About two thirds of patients are in advanced stage at the time of their first surgery, primarily for the lack of a high effective screening test as well as unknown pathophysiology in early ovarian cancer development. In early ovarian cancer comprehensive staging should be done, while in patients with advanced disease standard approach should include maximal effort in surgical cytoreduction.

Ključne riječi

ovarian cancer; endometrial cancer; cervical cancer; surgery; staging

Hrčak ID:

281497

URI

https://hrcak.srce.hr/281497

Datum izdavanja:

7.12.2006.

Podaci na drugim jezicima: hrvatski

Posjeta: 338 *