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The Role of Minimally Invasive and Minimally Radical Surgery in Cervical and Endometrial Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 1 September 2026 | Viewed by 698

Special Issue Editors

British Surgical Gynaecological Oncology Group (BSGOG), Newcastle-upon-Tyne, UK
Interests: gynaecological oncology surgery; cervical cancer; endometrial cancer; ovarian cancer
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Centre Hospitalier Universitaire de Québec, Quebec, QC, Canada
Interests: fertility sparing surgery; minimally invasive surgery; cervical cancer

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Guest Editor
Centre Jean-Perrin, Clermont-Ferrand, France
Interests: surgical oncology; gynaecological oncology surgery; cervical cancer; endometrial cancer; ovarian cancer

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Guest Editor
Padova University Hospital, Padova, Italy
Interests: surgical oncology; gynaecological oncology surgery; cervical cancer; endometrial cancer; ovarian cancer
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Guest Editor
Institut Universitaire du Cancer de Toulouse-Oncopole, Institut Claudius Regaud, Toulouse, France
Interests: surgical oncology; gynaecological oncology surgery; cervical cancer; endometrial cancer; ovarian cancer

Special Issue Information

Dear Colleagues,

Randomized controlled trials that transform surgical practice within a global context are a rare phenomenon. Yet, in the field of surgical gynaecological oncology, we have been rewarded with a number of landmark studies in recent years, resulting in a series of hotly debated sessions at major conferences and an explosion of editorials in eminent journals.

The first of these studies [1], and the least contentious, authenticated the use of a laparoscopic approach for performing a simple hysterectomy in early-stage endometrial cancer. The next of these studies [2] was diametrically different in its outcome and brought the surgical practice of a laparoscopic approach to radical hysterectomy in cervical cancer to an almost immediate halt. The final of these studies [3] challenged the central hallmark of surgical gynaecological oncologists’ identity and the orthodoxy of surgical gynaecological oncology as a discrete institution by questioning and disproving the need for radicality in early-stage cervical cancer.

The above studies have stimulated the surgical gynaecological oncology community to focus their research teams and investigate the pathophysiological mechanisms underlying these surgical outcomes. This Special Issue of cancers is in recognition of the work currently being undertaken by researchers across the globe in the fields of minimally invasive surgery as well as minimising surgical radicality in the treatment of cervical and endometrial cancer.

References:

  1. Janda M, Gebski V, Davies LC, et al: (2017) Effect of total laparoscopic hysterectomy vs total abdominal hysterectomy on disease‐free survival among women with stage I endometrial cancer: a randomized clinical trial. JAMA;317(12):1224‐33.
  2. Ramirez PT, Frumovitz M, Pareja R, et al: (2018) Minimally invasive versus abdominal radical hysterectomy for cervical cancer. N Engl J Med 379:1895-1904.
  3. Plante, M. ∙ Kwon, J.S. Ferguson, S, et al: (2024) Simple versus radical hysterectomy in women with low-risk cervical cancer. N Engl J Med; 390:819-29.

Dr. Raj Naik
Dr. Marie Plante
Dr. Christophe Pomel
Prof. Dr. Roberto Tozzi
Dr. Gwénaël Ferron
Guest Editors

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cervical cancer
  • endometrial cancer
  • laparoscopic surgery
  • minimally invasive surgery
  • surgical oncology
  • fertility-sparing surgery
  • non-radical surgery
  • conservative surgery

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Published Papers (1 paper)

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Research

11 pages, 1035 KB  
Article
Are Uterine Manipulators Harmful in Minimally Invasive Endometrial Cancer Surgery? A Retrospective Cohort Study
by Maxime Côté, Marie-Claude Renaud, Alexandra Sebastianelli, Jean Grégoire, Ève-Lyne Langlais, Narcisse Singbo and Marie Plante
Cancers 2025, 17(24), 3906; https://doi.org/10.3390/cancers17243906 - 6 Dec 2025
Viewed by 440
Abstract
Objective: The objective of our study was to assess the oncological safety of uterine manipulators (UMs) in apparent early-stage (FIGO I-II 2009) endometrial cancer treated by minimally invasive surgery (MIS). Methods: Our single-center retrospective study includes patients who underwent endometrial cancer surgery for [...] Read more.
Objective: The objective of our study was to assess the oncological safety of uterine manipulators (UMs) in apparent early-stage (FIGO I-II 2009) endometrial cancer treated by minimally invasive surgery (MIS). Methods: Our single-center retrospective study includes patients who underwent endometrial cancer surgery for apparent early-stage disease by either laparoscopy or by robotic or laparoscopic-assisted vaginal hysterectomy from November 2012 to December 2020. Data on UMs, isolated tumor cells (ITCs), cytology, lymphovascular space invasion, free cancer cells in fallopian tubes, stage, histology and grade were collected. Primary and secondary outcomes were cancer recurrence and disease-specific death. Kaplan–Meier curves and multivariate logistic regression were used for statistical analysis. Results: A total of 930 women with early-stage endometrial cancer were included; 789 (84.8%) had hysterectomy with a uterine manipulator and 141 (15.2%) without. A total of 88% had endometrioid histology, 71.6% were grade 1 and 95.7% had stage I disease. A higher risk of recurrence was observed with the Hohl manipulator (HR: 2.83. 95% CI: 1.004–7.98 p = 0.0492) on univariate analysis. On multivariate analysis, neither UM was associated with recurrence. With a mean follow-up of 48 months (range 3–118), no effect was seen on disease-specific death in either Hohl or V-Care (HR: 1.66. 95% CI: 0.48–5.70 and HR:1.29. 95% CI: 0.33–4.98). In high-grade histologies, UMs were strongly associated with recurrence (HR: 12.1. 95% CI: 1.52–96.6 p = 0.019) and disease-specific death (HR: 10.2. 95% CI: 1.12–92.1 p = 0.032). Conclusions: The use of UMs in MIS for endometrial cancer was associated with higher rates of recurrence without affecting disease-specific death, except in high-grade histologies. Full article
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