New study on cervical cancer | praxisvita.de

In the early stages of cervical cancer, the main element of therapy is usually called a hysterectomy – an operation that involves removing a portion of the cervix or the entire uterus. This can be done as an abdominal hysterectomy, that is, via an abdominal incision. Another solution consists of minimally invasive procedures, in which the uterus is minced and aspirated (laparoscopically badisted supracervical hysterectomy) by small incisions in the abdominal wall (laparoscopy) or by the bad. In the latter method, there are two options: To separate the uterus and cervix from the uterus in order to remove them from their suspension device and their blood vessels, the instruments are inserted either badlly ( badl hysterectomy) or Laparoscopic Laparoscopy (laparoscopically badisted hysterectomy).

Stopped because of worse chances of survival

In two studies, researchers now have the chance to recover Cervical cancer after laparoscopic surgery with those after open abdominal surgery compared. Scientists at the MD Andersen Cancer Center in Houston evaluated data from more than 600 women operated in clinics around the world. In half of the women, the uterus was removed minimally, in the other half, by abdominal section.

"Patients who had minimal invasive surgery were four times more likely to relapse than those who underwent open surgery," states the study's author, Dr. med. Pedro Ramirez. A safety group responsible for the study ended the experiment when it became clear that women in the minimal invasion group clearly had a distinct disadvantage. Four and a half years after the intervention, 94% of patients in this group were still alive and 99% of women undergoing fasting were alive.

In another study, scientists at Northwestern University in Evanston, Illinois, came to the same conclusion: among a national group of patients with cervical cancer, nine to One hundred women who had minimal invasive surgery died four years later. Of the patients undergoing abdominal surgery, only five percent had died.

Many questions are open

Why the minimally invasive procedure increases the chances of recovery, can not clarify either of the two studies. Houston researchers suggest that carbon dioxide that guides the abdominal wall towards the abdomen plays a role in elevating the abdominal wall. There is evidence that this gas can affect the growth and spread of cancer cells.

Other puzzles show that the phenomenon does not seem to apply to all types of cancer: Previous studies suggest that minimally invasive hysterectomy is safe, for example in tumors of the uterus, say the authors. As the prognosis for patients in a purely badl hysterectomy, that is to say without abdominal cut, fails, it has also not been responded to studies.

sources:
Ramirez, P.T. et al. (2018): Radical invasive versus radical abdominal radical hysterectomy for cervical cancer, in: New England Journal of Medicine.

Melamed A. et al. (2018): Survival after minimally invasive radical hysterectomy for early-stage cervical cancer, in: New England Journal of Medicine.