The field of gynecologic oncology has undergone an evolution, mirroring the growing knowledge of the pathophysiology of gynecologic malignancies and the introduction of new treatment modalities and innovative techniques. The introduction of targeted therapies, precision medicine, genomic profiling, genetic testing,…
Pelvic exenteration, the en bloc removal of the pelvic organs, is indicated for central recurrent or persistent gynecologic cancer, including cervical, endometrial, vaginal, or vulvar cancer. Even when performed in the setting of specialized centers by highly skilled surgeons, pelvic…
Pelvic exenteration (PE) is a very complex procedure, even currently. In addition to unique surgical erudition and interdisciplinary surgical team involvement, these operations require special expertise for the right candidate selection, postoperative care, and handling of complications. Because of the…
Radical cytoreduction consists of complex surgical procedures that may include extended peritonectomy, diaphragmatic resections, lymphadenectomy, and multiple visceral resections. As a result, it may be difficult to determine which of these innumerable procedures contributes to a specific complication. Patients undergoing…
Pelvis In early stages, removal of the adnexa involved by tumor, a total abdominal hysterectomy with bilateral salpingo-oophorectomy, pelvic and paraaortic lymphadenectomy, and omentectomy are required as part of the surgical staging. Conservative procedures including unilateral salpingo-oophorectomy may be an…
The prognostic implications associated with the resection of all visible residual disease in patients with advanced-stage ovarian cancer have been clearly established in several retrospective and nonrandomized prospective studies. In 2013, Landrum and colleagues detailed the survival outcomes of patients…
Background The current standard of care for advanced epithelial ovarian cancer (AEOC) is a combination of cytoreductive surgery and paclitaxel and platinum-based chemotherapy. The size of residual disease has been repeatedly proven to be a crucial prognostic factor for affected…
The majority of patients with endometrial cancer have early-stage uterine-confined disease at presentation. However, many patients will still undergo a complete pelvic and sometimes paraaortic lymphadenectomy for staging purposes despite having disease confined to the uterus, resulting in prolonged operating…
The mainstay of treatment in patients affected by endometrial cancer is surgery, including simple hysterectomy and bilateral salpingo-oophorectomy with or without lymphadenectomy. Regardless of the stage of disease, removal of the uterus is recommended in every patient unless there are…
Along with ovarian cancer debulking and radical hysterectomy, pelvic and paraaortic lymph node dissections are procedures that define gynecologic oncology. Complete pelvic and paraaortic lymphadenectomies (open and transperitoneal) for staging in early-stage cervical cancer are similar in approach to procedures…