[Future prospects of surgical gynecology in treatment of cervix carcinoma]

Both the gain of new tumor biological insights, particularly the relevance of tumor oxygenation and vascularity in addition to tumor volume for disease progression and resistance towards therapy, and the development of novel ablative and reconstructive pelvic surgical techniques may lead to a paradigm shift in the treatment of cancer of the uterine cervix. With respect to stage, size, and predicted tumor biological features, either less radical or extended radical surgical treatment should be investigated in clinical trials with standard therapy (abdominal radical hysterectomy and pelvic/periaortic lymph node dissection for early-stage disease and percutaneous/intracavitary radiation for locally advanced disease) as control. Improving the therapeutic index and increasing the therapeutic window in cervical cancer appear to be an exciting challenge for surgical gynecology in the future.