Perspective on the Advances in Surgical Gynecologic Oncology View PDF

^*Charvika Lakavath
Medicine, Malla Reddy Institute Of Medical Sciences, Hyderabad, Telangana, India
Prasanna Satya Kumar Vurma Ardhani
Medicine, Konaseema Institute Of Medical Sciences And Research Foundation, Amalapuram, Andhra Pradesh, India
Praharsha Nalagati
Medicine, Mamata Medical College, Khammam, Telangana, India
Rithu Reddy
Medicine, Navodaya Medical College, Raichur, Karnataka, India

^*Corresponding Author:

Charvika Lakavath
Medicine, Malla Reddy Institute Of Medical Sciences, Hyderabad, Telangana, India

Published on: 2025-01-13

Abstract

In the management of women with gynecological malignancies, surgery remains the cornerstone. Gynecological oncology is a well-established sub-specialty of cancer care due to a well-defined training program for doctors and centralized patient referrals in most countries. Throughout time, gynecological oncologists have collaborated across disciplines to improve treatment approaches. Aside from our abdominal colleagues, our hepatobiliary and thoracic colleagues have joined this interprofessional effort as the anatomic fields of gynecologic oncology surgery expanded. A complex clinical scenario has led to major changes in the surgical approach in gynecological oncology. Early-stage cancer patients have generally been treated with minimal-access surgery rather than open surgery. The goal of adjuvant treatment has been to reduce the tumor load in women with advanced-stage disease by performing multivisceral surgery and staging the extent of the disease. Additionally, surgical options have been evaluated for women with recurrent disease or as part of symptom palliation. To describe recent advances in surgical gynecologic oncology, the authors tried to provide examples of key contributions

Keywords

Cervical cancer, Ovarian cancer, Endometrial cancer, Gynecologic cancer, Surgery

Introduction

We have seen a major paradigm shift in the surgical management and multidisciplinary care of patients with gynecologic cancers of all primary sites, including endometrial, cervical, and ovarian cancers. As laparoscopic surgery became more popular in the late 1980s, the concept of minimal access surgery became a reality. A laparoscope is traditionally used directly through a few ports using straight instruments. Laparoscopic surgery, in which instruments rotate and are activated by electric arms, is currently being replaced by robotic surgery and single-port surgery [1]. Based on GLOBOCAN 2023 data, there were 746,579 new cancer cases in women on the Indian subcontinent. Nearly 210,646 of these cases were gynecological cancers. Family physicians, general practitioners, and gynecologists are often women's first points of contact with health care. Most countries have traditionally treated gynecological cancer with generalists. As the management of these women has become more complex and challenging, a new sub-specialty has emerged-gynecologic oncology. Medical oncologists specializing in gynecological oncology, working in multidisciplinary settings, provide better treatment outcomes for women with gynecological cancers than physicians with less specialized training [2]. The reproductive age group makes up about one-fifth of all women with gynecological cancers. The multidisciplinary approach to gynecologic oncology can include tailored surgical techniques, fertility preservation, hormone modulators, targeted therapy, and immunotherapy to treat these cancers holistically. The subspecialty originated in the 1970s in the USA and has spread to middle-income countries such as India, where the burden of cancer is a major factor.