[Oncological pelvic surgery from a gynecological perspective]

Area of Science:

• Gynecologic Oncology
• Surgical Anatomy
• Developmental Biology

Context:

• Established gynecological cancer surgeries rely on mature organism anatomy and radial tumor spread models.
• Despite adequate surgical resection, local tumor relapses occur, often necessitating adjuvant radiation therapy.
• Adjuvant radiation increases treatment-related morbidity in gynecological cancer patients.

Purpose:

• To develop novel gynecological cancer operations based on ontogenetic anatomy and developmental principles.
• To redefine anatomical understanding of local tumor spread in gynecological cancers.
• To improve local tumor control rates and reduce treatment-related morbidity.

Summary:

• The Leipzig School developed new gynecological cancer operations (TMMR, PMMR, VFR, LEER) using ontogenetic anatomy and tissue mapping.
• These techniques identify permissive compartments for tumor spread based on developmental processes.
• TMMR, PMMR, and VFR achieve >95% local control in early-stage lower/middle female genital tract cancers without adjuvant radiation.
• LEER offers sustained tumor control for advanced, recurrent, and distal vaginal cancers.

Impact:

• Achieves high local control rates (>95%) for early-stage gynecological cancers without adjuvant radiation.
• Reduces treatment-related morbidity associated with adjuvant radiation therapy.
• Provides effective tumor control for locally advanced, recurrent, and distal vaginal cancers.