Surgical treatment of cervical cancer

Background Surgery represents the first choice for treatment of early cervical carcinoma (FIGO IA1 to FIGO IIa according to Federation Internationale de Gynecologie et d'Obstetrique). The extent of surgical therapy for the patient should be determined based on the patient's age and tumor spread, particularly if fertility preservation is desired. More recently, less radical surgical procedures and concepts for sentinel lymph node biopsy are increasingly used in order to reduce mortality and morbidity. Controversy is currently emerging in the context of new studies regarding the choice of surgical approach. Objective In this article, surgical options for the treatment of cervical cancer are reviewed. Materials and methods An overview of the current study situation and literature is provided, taking into consideration the current German S3 guideline on cervical carcinoma. Results Localized cervical cancer (<= FIGO IIA) is primarily treated by surgery. Recent studies, e.g. SHAPE, are investigating whether less radical surgical procedures can provide adequate oncological safety. A fertility-preserving approach is possible up to stage IB1 depending on the presence of risk factors. After the study results of the LACC trial were published with increased recurrence and mortality rate in the group undergoing laparoscopic surgery compared to the laparotomy group, patients must be informed about these data prior to decision making regarding the route of hysterectomy. Conclusion The treatment of cervical cancer should be conducted according to the stage. Surgery is key in the treatment of early cervical carcinoma. Even less radical procedures seem to provide adequate oncological safety.