MODERN ASPECTS OF SURGICAL TREATMENT METHODS FOR CERVICAL CANCER

Abstract

Cervical cancer is one of the most common malignant neoplasms of the female reproductive system. In the early stages of the disease, satisfactory treatment outcomes can be achieved using radical surgery and combined radiotherapy, with five-year overall survival rates exceeding 93% (Melamed A., 2018). In patients with cervical cancer stages IB2–IIIB, the main treatment modalities currently used—radiotherapy and chemoradiotherapy—allow achieving five-year survival rates ranging from 12% to 75% (de Foucher T. et al., 2019). Surgery for locally advanced cervical cancer remains one of the unresolved problems in gynecologic oncology. The technical complexity of operations following neoadjuvant chemotherapy gives rise to discussions regarding the necessity of their use (Ramirez P.T. et al., 2018; Berlev I.V., 2015). Endovideosurgical procedures in such patients are performed only by a limited number of authors, and the treatment outcomes remain insufficiently studied. Thus, existing studies have not yet identified clear advantages of any particular approach to the comprehensive treatment of patients with cervical cancer stages IB2–IIIB. The conditions for performing radical surgery and the feasibility of using video-endoscopic technologies have not been clearly defined. There are no randomized studies evaluating long-term outcomes in patients with cervical cancer stages IB2–IIIB treated with neoadjuvant chemotherapy followed by radical surgery. All of the above indicates that the treatment of patients with cervical cancer stages IB2–IIIB represents an important problem in gynecologic oncology, and the study of the effectiveness of various comprehensive treatment options for these patients is relevant and timely.