Cervical Cancer Stage IIIB Clinical Trial
Official title:
Clinical Trial of Laparoscopic Pelvic and Para-aortic Lymphadenectomy and Uterine Blood Vessel Blocking for Precision Diagnosis and Treatment in Advanced Cervical Cancer
Cervical cancer is the most common reproductive malignancy in developing country. Due to
local invasion, radical hysterectomy cannot be performed in advanced cervical cancer (FIGO
IIB - IVA) , so that radiation combined with chemoradiation (RCTX) is a traditional
treatment nowadays. Lack of precise treatment strategies, recurrent ratesand metastasisis
high ,and the 5-year survival rate is less than 50%. Therefore, it needs to explore a new
strategy for improving the prognosis of advanced cervical cancer.
The prognosis of cervical cancer is closely related to its stages ,while the current FIGO
clinical stage is too subjective , for example different gynecologic oncologists may give
different diagnosis to the same patient. MRI, CT, PET/CT imaging examinations are commonly
used as a referrence for clinical staging, but the sensitivity and specificity are not
satisfied. In addition, lymph node metastasis significantly impacts the prognosis of
cervical cancer . However, the lymph node invasion is not in current staging criteria.
Precision treatment after surgical staging is recommended by NCCN recently .Surgical staging
in patients with advancedcervical cancer is safe and does not delay primary RCTX in few
randomized study.Whether overall survival benefit the long-term clinical follow-up surgical
staging is unknown.Blocking bilateral uterine artery can effectively reduce the tumor size
and increase the operability , which has been conformed in locally advanced cervical cancer.
Furthermore, ovarian dysfunction caused by RCTX could be avoided by ovarian transposition
via surgical staging .
Based on this, we suggesta new surgical stagingfor patients with advanced cervical cancer ,
which includinglaparoscopic pelvic and para-aortic lymphadenectomy , uterine blood vessel
blocking and ovarian transportation, in order to perform individualized postoperative RCTX,
reduce tumor load , preserve ovarian function and improve life quality.
n/a
Observational Model: Case Control, Time Perspective: Prospective
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