Surgery in Cervical Cancer
Ce dossier présente une étude épidémiologique (2 461 patientes ; durée médiane de suivi : 45 mois) et un essai (631 patientes, âge moyen : 46 ans) comparant, du point de vue des taux de survie, l'efficacité d'une hystérectomie radicale mini-invasive et d'une hystérectomie radicale par voie ouverte pour traiter un cancer du col utérin de stade précoce
Cervical cancer is the fourth most frequently diagnosed cancer and the fourth leading cause of cancer-related death in women worldwide.1 For early-stage disease, surgical removal of the uterus remains the primary treatment and has the greatest effect on long-term survival. However, abdominal (“open”) radical hysterectomy is associated with complications, including a risk of lymphedema in the legs and bladder and sexual dysfunction.2 Recently, a greater emphasis on reducing surgical morbidity has led to the development of minimally invasive techniques. Despite a paucity of randomized trials, retrospective data suggesting superior surgical and similar oncologic results led to widespread acceptance of minimally invasive radical hysterectomy.2,3 Laparoscopy-based and robotic techniques are currently the dominant methods of performing radical hysterectomy in the United States.
New England Journal of Medicine , éditorial en libre accès, 2017