Minimally invasive surgery in gynecological cancers: update and systematic review

Introduction: In the last decades, the introduction of laparoscopy and, more recently, of robotic surgery, offered new options for surgical treatment also in gynecological malignancies, as an alternative to open surgery. When considering the best surgical treatment option for gynecological malignanc...

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Main Authors: Elisa Scarpelli, Giulia Armano, Luciano Monfardini, Alissa Valenti, Giuseppe Barresi, Alessandra De Finis, Isabella Rotondella, Davide Scebba, Diana Butera
Format: Article
Language:English
Published: IMR Press 2022-04-01
Series:Clinical and Experimental Obstetrics & Gynecology
Subjects:
Online Access:https://www.imrpress.com/journal/CEOG/49/4/10.31083/j.ceog4904088
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author Elisa Scarpelli
Giulia Armano
Luciano Monfardini
Alissa Valenti
Giuseppe Barresi
Alessandra De Finis
Isabella Rotondella
Davide Scebba
Diana Butera
author_facet Elisa Scarpelli
Giulia Armano
Luciano Monfardini
Alissa Valenti
Giuseppe Barresi
Alessandra De Finis
Isabella Rotondella
Davide Scebba
Diana Butera
author_sort Elisa Scarpelli
collection DOAJ
description Introduction: In the last decades, the introduction of laparoscopy and, more recently, of robotic surgery, offered new options for surgical treatment also in gynecological malignancies, as an alternative to open surgery. When considering the best surgical treatment option for gynecological malignancies, evidence about safety, feasibility, and oncological outcomes must be taken into account, to offer the best treatment to the patient. The present review aims to provide an updated scenario over the available evidence in the use of minimally invasive surgery (MIS) in gynecological malignancies. Material and methods: An electronic search was performed using the following keywords: ‘minimally invasive surgery’ and ‘gynecology’, ‘minimally invasive surgery’ and ‘endometrial cancer’, ‘minimally invasive surgery’ and ‘ovarian cancer’, ‘minimally invasive surgery’ and ‘cervical cancer’. The agreement about potential relevance was reached by consensus of the researchers and according to PRISMA statement guidelines. Systematic reviews, meta-analyses, clinical trials, and original articles were included in the present review. Results: Fifty-eight studies were considered eligible for the study, 23 studies regarding MIS in endometrial cancer (EC), 19 studies on MIS in ovarian cancer (OC), and 16 studies regarding MIS in cervical cancer (CC). The total of patients enrolled was 180,057, 131,430 in the EC group, 23,774 in the OC groups, and 24,853 in the CC group. Conclusions: According to the available evidence and current clinical practice, MIS is undoubtedly the gold standard for early-stage EC treatment and may represent an acceptable option even in high-risk EC patients. Concerning OC, MIS is a safe and useful tool for staging purposes in advanced-stage disease, and a treatment option only in high volume centres with expert oncologic surgeons. On the contrary, MIS should be abandoned in the context of CC, exception made for well-selected patients, who received adequate counselling about current evidence.
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spelling doaj.art-a849b1140ce04912870facb829c6e3552022-12-22T02:11:15ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632022-04-014948810.31083/j.ceog4904088S0390-6663(22)01742-0Minimally invasive surgery in gynecological cancers: update and systematic reviewElisa Scarpelli0Giulia Armano1Luciano Monfardini2Alissa Valenti3Giuseppe Barresi4Alessandra De Finis5Isabella Rotondella6Davide Scebba7Diana Butera8Department of medicine and surgery, University of Parma, 43125 Parma, ItalyDepartment of medicine and surgery, University of Parma, 43125 Parma, ItalyDepartment of medicine and surgery, University of Parma, 43125 Parma, ItalyDepartment of medicine and surgery, University of Parma, 43125 Parma, ItalyDepartment of medicine and surgery, University of Parma, 43125 Parma, ItalyDepartment of medicine and surgery, University of Parma, 43125 Parma, ItalyDepartment of medicine and surgery, University of Parma, 43125 Parma, ItalyDepartment of medicine and surgery, University of Parma, 43125 Parma, ItalyDepartment of medicine and surgery, University of Parma, 43125 Parma, ItalyIntroduction: In the last decades, the introduction of laparoscopy and, more recently, of robotic surgery, offered new options for surgical treatment also in gynecological malignancies, as an alternative to open surgery. When considering the best surgical treatment option for gynecological malignancies, evidence about safety, feasibility, and oncological outcomes must be taken into account, to offer the best treatment to the patient. The present review aims to provide an updated scenario over the available evidence in the use of minimally invasive surgery (MIS) in gynecological malignancies. Material and methods: An electronic search was performed using the following keywords: ‘minimally invasive surgery’ and ‘gynecology’, ‘minimally invasive surgery’ and ‘endometrial cancer’, ‘minimally invasive surgery’ and ‘ovarian cancer’, ‘minimally invasive surgery’ and ‘cervical cancer’. The agreement about potential relevance was reached by consensus of the researchers and according to PRISMA statement guidelines. Systematic reviews, meta-analyses, clinical trials, and original articles were included in the present review. Results: Fifty-eight studies were considered eligible for the study, 23 studies regarding MIS in endometrial cancer (EC), 19 studies on MIS in ovarian cancer (OC), and 16 studies regarding MIS in cervical cancer (CC). The total of patients enrolled was 180,057, 131,430 in the EC group, 23,774 in the OC groups, and 24,853 in the CC group. Conclusions: According to the available evidence and current clinical practice, MIS is undoubtedly the gold standard for early-stage EC treatment and may represent an acceptable option even in high-risk EC patients. Concerning OC, MIS is a safe and useful tool for staging purposes in advanced-stage disease, and a treatment option only in high volume centres with expert oncologic surgeons. On the contrary, MIS should be abandoned in the context of CC, exception made for well-selected patients, who received adequate counselling about current evidence.https://www.imrpress.com/journal/CEOG/49/4/10.31083/j.ceog4904088minimally invasive surgeryendometrial cancerovarian cancercervical cancer
spellingShingle Elisa Scarpelli
Giulia Armano
Luciano Monfardini
Alissa Valenti
Giuseppe Barresi
Alessandra De Finis
Isabella Rotondella
Davide Scebba
Diana Butera
Minimally invasive surgery in gynecological cancers: update and systematic review
Clinical and Experimental Obstetrics & Gynecology
minimally invasive surgery
endometrial cancer
ovarian cancer
cervical cancer
title Minimally invasive surgery in gynecological cancers: update and systematic review
title_full Minimally invasive surgery in gynecological cancers: update and systematic review
title_fullStr Minimally invasive surgery in gynecological cancers: update and systematic review
title_full_unstemmed Minimally invasive surgery in gynecological cancers: update and systematic review
title_short Minimally invasive surgery in gynecological cancers: update and systematic review
title_sort minimally invasive surgery in gynecological cancers update and systematic review
topic minimally invasive surgery
endometrial cancer
ovarian cancer
cervical cancer
url https://www.imrpress.com/journal/CEOG/49/4/10.31083/j.ceog4904088
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