Is adjuvant hysterectomy an option after radio-chemotherapy for locally advanced cervical cancer? A review.
Journal Title: Journal of Clinical and Investigative Surgery - Year 2018, Vol 3, Issue 1
Abstract
Objective. The purpose of this paper is to review the current concepts in the literature regarding the beneficial effects of adjuvant surgery after concurrent radio-chemotherapy for locally advanced cervical cancer. Method. Research of the literature was performed using PubMed databases in order to find articles relevant to the central topic. The PICOS criteria were used to filter the results. The paper was then structured according to the PRISMA guideline. Results. 50 individual papers were analyzed and sorted according to their relevance for the topic. 18 were classified as relevant. There was little agreement as to how beneficial adjuvant hysterectomy is in locally advanced cervical cancer after chemoradiotherapy. Some articles concluded that patients with a total clinical response after initial treatment might have superior progression-free survival and overall survival after surgery. 2 articles underlined the importance of accurate restaging after primary treatment. The lack of benefit for surgery in patients with bulky disease or persistent adenopathies was agreed upon in all cases. Conclusions. The decision for adjuvant hysterectomy with or without lymphadenectomy is a controversial one and has to be personalized and taken in a multidisciplinary team.
Median forehead flap - beyond classic indication
Introduction. The paramedian forehead flap is one of the best options for reconstruction of the median upper two-thirds of the face due to its vascularity, color, texture match and ability to resurface all or part of the...
Stenotic ligature: a simple technique for managing distal hypoperfusion ischemic syndrome following arteriovenous fistulas
Introduction. Distal Hypoperfusion Ischemic Syndrome (DHIS) is a multifactorial debilitating condition causing peripheral ischemia and potentially tissue necrosis. In an effort to further refine its surgical treatment we...
A case of silent colonic lesions associated with streptococcus gallolyticus, bacteremia and endocarditis
We present a clinical case of synchronous colonic lesions, histologically different, associated with streptococcus gallolyticus subsp. gallolyticus (Sgg)/ Streptococcus bovis biotype I, bacteremia and infective endocardi...
Gallstone ileus - the double challenge: case report and review of the literature
Gallstone ileus is a rare condition which occurs as an evolutive complication of biliary lithiasis. It occurs after stone migration from extrahepatic biliary tree to the digestive lumen, mostly through a biliary-enteric...
Mucinous cystadenoma of the pancreas associated with pregnancy. Case report and review of the literature
Objective. We present a rare pathology with uncommon onset. Background. Mucinous cystic pancreatic neoplasms (MCNs) are rare tumors, which generally occur in the fifth and sixth decades of women. Although some tumours ar...