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An ontogenetic approach to gynecologic malignancies
Inês A Santiago1, António P Gomes2, Richard J Heald3
1Radiology Department, Champalimaud Foundation, Av. Brasília, 1400-038, Lisbon, Portugal. ines_agp_santiago@hotmail.com.
Insights Into Imaging
|April 17, 2016
Summary
Ontogenetic anatomy guides cancer surgery by resecting entire embryologic compartments, improving outcomes. This compartment-permissive theory is validated by rectal and gynecologic cancer surgeries.
Area of Science:
- Surgical Oncology
- Embryology
- Anatomy
Background:
- Ontogenetic anatomy maps embryologically defined body compartments, crucial in pelvic structures.
- Traditional cancer surgery relies on wide excision, but ontogenetic theory proposes compartment-specific spread.
- Local tumor spread is facilitated within its origin compartment but suppressed at compartment borders early in development.
Purpose of the Study:
- To explore the application of ontogenetic anatomy principles in cancer surgery.
- To highlight the importance of compartment-based resection for optimal local cancer control.
- To review evidence supporting ontogenetic theory in rectal and gynecologic malignancies.
Main Methods:
- Review of surgical principles based on ontogenetic anatomy.
- Analysis of outcomes from total mesorectal excision in rectal cancer.
- Evaluation of innovative surgical approaches in gynecologic oncology.
Main Results:
- Optimal local cancer control is achieved through whole compartment resection with intact margins.
- Total mesorectal excision for rectal cancer exemplifies successful application of these principles.
- Emerging gynecologic cancer surgeries based on ontogenetic theory demonstrate promising results.
Conclusions:
- Ontogenetic anatomy provides a framework for understanding embryologically determined body compartments.
- Tumor growth is compartment-permissive, not isometrical, according to ontogenetic theory.
- Ontogenetic principles are strongly supported by outcomes in rectal and gynecologic cancer surgery.
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