Advances in the Surgical Management of Cervical Cancer

Cervical cancer is the third most common gynecologic malignancy in the United States. Traditionally, a radical hysterectomy with bilateral salpingo-oophorectomy with lymph node assessment had been the standard of care; however, there has been a recent shift towards less radical surgery with the establishment of the oncologic safety of conization (as fertility preserving surgery), and simple hysterectomy for certain subgroups of patients with early-stage disease. In addition, uptake in the utilization of sentinel lymph node mapping, compared to systematic lymphadenectomy, has translated to improved perioperative outcomes. While laparotomy is the preferred mode of surgery for patients with cervical cancer, emerging data suggest that protective maneuvers may not compromise oncologist outcomes and multiple clinical trials are evaluating the oncologic safety of minimally invasive surgery. In this present review, we summarize recent advances in surgical management in patients with cervical cancer.