子宫颈癌手术治疗及放化疗新观点

New views on surgical treatment for cervical can⁃cer and chemoradiotherapy

子宫颈癌的病因已经明晰,然而治疗方法并未发生重大变革,早期患者采取手术治疗,中晚期患者采取放化疗,依然是目前主要的治疗方法。手术治疗微创化是临床医学发展的必然趋势,腹腔镜手术治疗子宫颈癌已经显现出巨大的优势,但是由于初期实践者缺乏微创无瘤防御的理念和严格的规范操作,造成术后患者复发率增高。故亟待总结经验,持续改进完善。手术切除范围更加强调精准化和个体化,趋向于避免盲目广泛切除正常组织,有助于降低手术难度和并发症,尤其注重于保护生育功能和免疫功能。新辅助化疗虽然作为权宜之计,但是越发彰显重要作用。术后是否选择放疗至关重要,放疗指征更加精细化和标准化。

The etiology of cervical cancer has become clear;however,there has been no significant change in treatment methods.Surgical intervention remains the primary treatment for early-stage patients,while ra⁃diotherapy and chemotherapy are employed for those in the middle and late stages.Minimally invasive surgery is an inevitable trend in the development of clinical medicine,with laparoscopic surgery demonstrating significant advantages in the treatment of cervical cancer.Nevertheless,due to a lack of awareness of minimally invasive tumor defense and strict stan⁃dardized procedures among early practitioners,the postoperative recurrence rate has increased.Therefore,there is an urgent need to summarize experiences and continuously improve and refine these procedures.More emphasis is put on precise and individualized surgical resection in terms of surgical resection scope,aiming to avoid indiscriminate removal of normal tis⁃sues,thereby reducing surgical difficulty and com⁃plications.Preservation of reproductive and immune functions is particularly emphasized.Although neo⁃adjuvant chemotherapy serves as a temporary measure,its importance is increasingly evident.The decision on postoperative radiotherapy is crucial,with indications becoming more refined and standardized.