“We can offer less invasive procedures to our female patients with below-the-belt cancers without compromising oncologic outcomes,” announced Amanda N. Fader, MD, Director, Kelly Gynecologic Oncology Service, and Associate Professor, Gynecology and Obstetrics, The Johns Hopkins School of Medicine. In fact, less may be more when it comes to minimally invasive surgery (MIS) for the primary treatment of certain gynecologic cancers, she added. Dr. Fader is an editorial board member for Gynecologic Oncology and serves on the NCCN Cervical/Uterine/Vulvar Cancers Panel.
Although MIS was initially used solely to aid in establishing a cancer diagnosis, it has now graduated to therapeutics, with various roles including staging, defining the extent of adjuvant therapy, and managing locoregional recurrence. In fact, laparoscopy has become the gold standard treatment of many gynecologic conditions, “both benign and malignant,” reported Dr. Fader. Many studies have shown improved outcomes with MIS,1,2 and a host of benefits have been reported, including fewer perioperative and postoperative complications, shorter hospital stays, improved cosmesis, faster recovery, and decreased costs. Furthermore, MIS may be beneficial for obese or elderly patients with many comorbidities, and less physical and psychologic trauma is another advantage.
However, admitted Dr. Fader, minimally invasive procedures have not been completely generalizable. “Despite level 1 evidence showing the benefits of laparoscopic hysterectomy and other minimally invasive procedures, there is still a 50% abdominal hysterectomy rate,” she said.
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Koh WJ, Greer B, Abu-Rustum NR. NCCN Clinical Practice Guidelines in Oncology: Uterine Neoplasms, Version 1.2017. Accessed April 14, 2017. To view the most recent version of these guidelines, visit NCCN.org.
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