Treatment of cervical squamous cell carcinoma with transabdominal lymph node resection and QM-C2 surgery: a surgical...

As one of the primary treatment modalities for early cervical cancer, surgical intervention focuses on removing sufficient tissue surrounding the cervix. According to the Querleu-Morronw (QM) classification, the traditional extensive hysterectomy is categorized as QM-C2. Lymph node metastasis is a major pathway for cervical cancer spread. Lymph node metastasis represents a significant independent risk factor influencing the prognosis of cervical cancer. The fundamental criteria for successful surgical management of malignant tumours are as follows: (I) complete removal of the affected tissue and a sufficient quantity of normal tissue surrounding the lesion; (II) complete removal of the lymph nodes within the corresponding region. Systematic pelvic lymph node dissection involves the removal of lymph nodes along the common iliac, external iliac, obturator, internal iliac, paracervical, and deep inguinal regions, as well as surrounding fatty tissue. This surgical approach is extensive, and although laparoscopic surgery offers superior visualization and more detailed anatomy, numerous authoritative guidelines, such as those from the National Comprehensive Cancer Network (NCCN), recommend open surgery as the gold standard for extensive hysterectomy. Clearly exposing the anatomical structures of the paracervical spaces and standardizing the resection of paracervical tissues are significant challenges in surgery. Therefore, a technique based on space and layer anatomy has been developed, allowing for accurate localization and standardization of surgical procedures, thereby reducing surgical trauma and postoperative complications. This article aims to describe the QM-C2 type precise anatomical open surgery and lymphadenectomy for early-stage cervical cancer.