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If a patient meets criteria for extrafascial hysterectomy for early-stage cervical cancer, how do you determine your surgical approach (abdominal vs laparoscopic)?

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Gynecologic Oncology · University of California Irvine Medical Center
Answered on · Updated on

For FIGO 1A1-1A2 (i.e., microinvasion which means no visible lesion) - I would perform a vaginal hysterectomy with bilateral salpingectomy (IA1) or robotic hysterectomy with bilateral salpingectomy-nodes (IA2); for FIGO 1B1 with no visible lesion (eg., post-conization), I would perform a robotic cys...

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Gynecologic Oncology · Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
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We shifted our surgical approach for radical hysterectomies due to the LACC trial, which did not include stage IA1 without LVSI. Criteria for extrafascial hysterectomies include tumor size less than 2 cm. In the SHAPE trial, recurrence rates were similar between those who had minimally invasive surg...

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Gynecologic Oncology · Vanderbilt University School of Medicine
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The LACC trial was a randomized, controlled trial of laparoscopic versus open radical hysterectomy in patients with cervical cancers less than or equal to 4 cm in size. This trial demonstrated reduced disease free and overall survival in patients who underwent laparoscopic radical as compared to ope...

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