Pelvic oncology surgery: what has changed and what will change.
Seance of wednesday 29 january 2025 (Gynécologie Actualités et recherches)
DOI number : 10.26299/r1q8-jc55/emem.2025.04.02
Abstract
The management of endometrial cancer is conditioned by molecular classification, with validation of the sentinel node procedure.
In cervical cancer, the role of the sentinel lymph node remains to be validated. The recommendations are that management of localized stages should begin with conization, in order to clarify prognostic factors and define the modalities for hysterectomy. The final results of the LACC trial confirm the value of laparotomy in certain cases.
In ovarian cancer, recent data have clarified the indications for CHIP. Lymph node surgery is now limited to certain stages; if curage is the reference, the sentinel lymph node procedure could one day have its place.
In vulvar surgery, indocyanine green also has its place for sentinel node procedures, but also for assessing the vitality of covering flaps.
In cervical cancer, the role of the sentinel lymph node remains to be validated. The recommendations are that management of localized stages should begin with conization, in order to clarify prognostic factors and define the modalities for hysterectomy. The final results of the LACC trial confirm the value of laparotomy in certain cases.
In ovarian cancer, recent data have clarified the indications for CHIP. Lymph node surgery is now limited to certain stages; if curage is the reference, the sentinel lymph node procedure could one day have its place.
In vulvar surgery, indocyanine green also has its place for sentinel node procedures, but also for assessing the vitality of covering flaps.