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Operativno zdravljenje bolnic z rakom materničnega vratu = Surgical treatment of patients with cancer of the cervix uteri
Rakar, Stelio
Today not only survival but also the quality of life is an important issue in deciding the surgical treatment of patients with cervical cancer. Attention ispaid to preserving organ function and ...especially reproduction function in young patients. For the choice of treatment of microinvasive cervical cancer we consider a scoring system based on evaluation of morphological criteria (cellular type, mitotic activity, type and depth of stromal invasion, defense reaction, lymphovascular space invasion). In the last period 71% of stage IA cases were treated by conization only. We performed radical abdominal hysterectomy (`Wertheim-Meigs-Novak) in patients with localized disease (90% five-year survival) and good general condition. In high risk cases postoperative irradiation is indicated. Most cases of stage IA can be treated conservatively with conization associated in 6-10% with laparoscopic pelvic lymphadenectomy. Even in stage IA2 cases, radical hysterectomy is an "overtreatment ". Radical hysterectomy is the method of choice in stage IB andIIA early disease. T'he radicality of the procedure can be adjusted to prognostic factors in order to avoid long-term postoperative morbidity and preserve good quality of life.
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