Cervical cancer 'surgery boost'

http://news.bbc.co.uk/go/rss/-/1/hi/health/8074525.stm

Version 0 of 1.

Subtle changes to major surgery for cervical cancer could improve survival by as much as 20%, researchers in Germany suggest.

For some women the only option is to undergo a radical hysterectomy but the disease may still come back.

Writing in The Lancet Oncology, the doctors said the new more highly targeted method was more effective and resulted in fewer complications.

Cancer Research UK agreed that the technique showed potential.

For the past 100 years radical hysterectomy has been the most widely used treatment for early-stage cervical cancer.

This new surgical technique seems to have the potential to help women with early-stage cervical cancer avoid some of the unpleasant long-term effects of a hysterectomy and radiotherapy Liz Woolf, Cancer Research UK

It involves removal of the uterus, cervix, a small portion of the upper part of the vagina and some soft tissue from within the pelvis.

The new surgical technique called mesometrial resection (TMMR) removes a specific, more defined, section which includes the fallopian tubes, uterus, and certain parts of the vagina, which the researchers said are the main areas of local tumour spread.

The idea behind the surgery is to prevent damage to nerves in the pelvis which can cause problems with bladder and bowel function after the operation.

Patients are also spared radiotherapy, which can cause further side-effects.

Recurrence

In the study, a total of 212 patients underwent TMMR between 1998 and 2008.

After 41 months, the cancer had returned in only 10 patients.

Even in high-risk patients, the recurrence rate was 5% - considerably better than the 28% overall recurrence rate seen in similar patients treated with the normal surgery, they said.

And the five-year survival in patients with positive lymph-nodes undergoing the new technique was 91%, compared with around 68-78% previously reported with standard surgery.

Researchers also reported that 63% of patients had no treatment-related complications and there were no severe complications.

Study leader Professor Michael Höckel from the University of Leipzig said: "Based on historical controls, TMMR without adjuvant radiation has the potential to improve survival by 15-20%."

He added that larger trials in different hospitals were now needed.

Liz Woolf, head of Cancer Research UK's patient information website CancerHelp UK, said: "This new surgical technique seems to have the potential to help women with early-stage cervical cancer avoid some of the unpleasant long-term effects of a hysterectomy and radiotherapy.

"While curing cancer must be the priority, it's important to do everything possible to improve the quality of life for women after cervical cancer treatment.

"But it will take time to confirm these results in larger trials, and then - if the technique is effective - to bring it into surgical training and practice across the UK."