Surgical Treatment for Early Cervical Cancer in the HPV Era - State of the Art

Q: What is the main focus of the article regarding early cervical cancer?

The article focuses on the state of the art in prevention, early diagnosis, and treatment, particularly the role of surgery in different stages of cervical cancer.

Q: How has the LACC study influenced the debate and practice of surgery?

It is discussed as having an impact on the scientific debate and clinical practice, especially in relation to minimally invasive approaches.

Q: Which surgical and diagnostic choices are highlighted for early-stage patients?

The article supports sentinel node biopsy instead of pelvic lymphadenectomy for tumors under 4 cm when imaging shows no suspicious lymph node involvement, and it discusses fertility-sparing surgery for young women seeking pregnancy.

Sep 24, 2026

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Cervical cancer remains a major global health problem, and advances in prevention, early detection, and management continue to evolve. The study reviews the role of surgery across disease stages, emphasizing how the LACC trial has shaped scientific discussion and clinical practice. It addresses contested use of minimally invasive surgery for tumors under 2 cm, and evaluates fertility-sparing options for young patients. It also highlights sentinel node biopsy for tumors under 4 cm without suspicious lymph nodes on imaging. Vaccination and early detection of pre-cancerous lesions are presented as the most effective public health measures.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

Introduction

Epidemiology

healthcare Review Surgical Treatment for Early Cervical Cancer in the HPV Era: State of the Art Mario Palumbo 1,†, Luigi Della Corte 2, *,†, Carlo Ronsini 3, Serena Guerra 1, Pierluigi Giampaolino 1 and Giuseppe Bifulco 1 Citation: Palumbo, M.; Della Corte, L.; Ronsini, C.; Guerra, S.; Giampaolino, P.; Bifulco, G. Surgical Treatment for Early Cervical Cancer in the HPV Era: State of the Art. Healthcare 2023, 11, 2942. [https://](https://)[ ](https://)[doi.org/10.3390/healthcare11222942](doi.org/10.3390/healthcare11222942) Academic Editor: Andrea Tittarelli Received: 7 August 2023 Revised: 12 October 2023 Accepted: 8 November 2023 Published: 10 November 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Department of Public Health, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; [mpalumbomed@gmail.com](mpalumbomed@gmail.com) (M.P.); [sere.guerra@gmail.com](sere.guerra@gmail.com) (S.G.); [pgiampaolino@gmail.com](pgiampaolino@gmail.com) (P.G.); [giuseppe.bifulco@unina.it](giuseppe.bifulco@unina.it) (G.B.) 2 Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples“Federico II”, 80131 Naples, Italy 3 Department of Woman, Child and General and Specialized Surgery, School of Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; [carlo.ronsini90@gmail.com](carlo.ronsini90@gmail.com) * Correspondence: [luigi.dellacorte@unina.it](luigi.dellacorte@unina.it) † These authors contributed equally to this work and share ﬁrst authorship. Abstract: Cervical cancer (CC) is the fourth most common cancer among women worldwide. The aim of this study is to focus on the state of the art of CC prevention, early diagnosis, and treatment and, within the latter, the role of surgery in the various stages of the disease with a focus on the impact of the LACC study (Laparoscopic Approach to Cervical Cancer trial) on the scientiﬁc debate and clinical practice. We have discussed the controversial application of minimally invasive surgery (MIS) for tumors < 2 cm and the possibility of fertility-sparing surgery on young women desirous of pregnancy. This analysis provides support for surgeons in the choice of better management, including patients with a desire for offspring and the need for sentinel node biopsy (SNB) rather than pelvic lymphadenectomy for tumors < 4 cm, and without suspicious lymph nodes' involvement on imaging. Vaccines and early diagnosis of pre-cancerous lesions are the most effective public health tool to tackle cervical cancer worldwide. Keywords: HPV; early cervical cancer; cervical dysplasia; surgical treatment 1. Introduction 1.1. Epidemiology Cervical cancer (CC) is the fourth most common female malignancy worldwide and represents a major global health problem [1] . In 2020, an estimated 604,127 new cases of cervix uteri neoplasms were diagnosed, and an estimated 341,831 deaths occurred worldwide. In accordance with the literature, it is possible to estimate 14,480 new cases of CC and 4290 deaths from this cancer among women in the United States in 2021 [1,2] . The age-standardised mortality rates account for almost half of the incidence rates (133 and 73 per 100,000, respectively) on a global scale [2] . In-depth analysis demonstrates the mortality-to-incidence ratio (MIR) to be 0.71 in Eastern Africa versus 0.211 in Northern Europe: a two-speed public health challenge [2] . Human papillomavirus (HPV) is a huge family of viruses, and an etiologic agent of the most common sexually transmitted infection in the United States, with highest infection rates in the population aged 20 to 25 ye

FAQs

What is the main focus of the article regarding early cervical cancer?

The article focuses on the state of the art in prevention, early diagnosis, and treatment, particularly the role of surgery in different stages of cervical cancer.

How has the LACC study influenced the debate and practice of surgery?

It is discussed as having an impact on the scientific debate and clinical practice, especially in relation to minimally invasive approaches.

Which surgical and diagnostic choices are highlighted for early-stage patients?

The article supports sentinel node biopsy instead of pelvic lymphadenectomy for tumors under 4 cm when imaging shows no suspicious lymph node involvement, and it discusses fertility-sparing surgery for young women seeking pregnancy.

Sep 24, 2026

Uploaded by Aldword