Extended mesometrial resection (EMMR): Surgical approach to the treatment of locally advanced cervical cancer based on the theory of ontogenetic cancer fields

Gynecologic Oncology
Benjamin WolfMichael Höckel

Abstract

Based on ontogenetic-anatomic considerations, we have introduced total mesometrial resection (TMMR) and laterally extended endopelvic resection (LEER) as surgical treatments for patients with cancer of the uterine cervix FIGO stages I B1 - IV A. For a subset of patients with locally advanced disease we have sought to develop an operative strategy characterized by the resection of additional tissue at risk for tumor infiltration as compared to TMMR, but less than in LEER, preserving the urinary bladder function. We conducted a prospective single center study to evaluate the feasibility of extended mesometrial resection (EMMR) and therapeutic lymph node dissection as a surgical treatment approach for patients with cervical cancer fixed to the urinary bladder and/or its mesenteries as determined by intraoperative evaluation. None of the patients received postoperative adjuvant radiotherapy. 48 consecutive patients were accrued into the trial. Median tumor size was 5cm, and 85% of all patients were found to have lymph node metastases. Complete tumor resection (R0) was achieved in all cases. Recurrence free survival at 5years was 54.1% (95% CI 38.3-69.9). The overall survival rate was 62.6% (95% CI 45.6-79.6) at 5years. Perioperativ...Continue Reading

Citations

Aug 31, 2020·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Alberto Ferreira BonaAnke Bergmann
Apr 26, 2020·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Giulio SozziVito Chiantera
Feb 14, 2019·Journal of Materials Chemistry. B, Materials for Biology and Medicine·Abid Hussain, Shengrong Guo
Oct 2, 2021·Der Pathologe·Lars-Christian HornUNKNOWN Mitglieder der AWMF-Leitlinienkommission zur Erstellung der S2k-Leitlinie Endometriose

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