Miaochun Xu

Advances in cervical cancer: current insights and future directions

Abstract In alignment with the World Health Organization's strategy to eliminate cervical cancer, substantial progress has been made in the treatment of this malignancy. Cervical cancer, largely driven by human papillomavirus (HPV) infection, is considered preventable and manageable because of its well‐established etiology. Advancements in precision screening technologies, such as DNA methylation triage, HPV integration detection, liquid biopsies, and artificial intelligence‐assisted diagnostics, have augmented traditional screening methods such as HPV nucleic acid testing and cytology. Therapeutic strategies aimed at eradicating HPV and reversing precancerous lesions have been refined as pivotal measures for disease prevention. The controversy surrounding surgery for early‐stage cervical cancer revolves around identifying optimal candidates for minimally invasive and conservative procedures without compromising oncological outcomes. Recent clinical trials have yielded promising results for the development of systemic therapies for advanced cervical cancer. Immunotherapies, such as immune checkpoint inhibitors (ICIs), antibody‐drug conjugates (ADCs), and targeted therapy have demonstrated significant effectiveness, marking a substantial advancement in cervical cancer management. Various combination therapies have been validated, and ongoing trials aim to enhance outcomes through the development of novel drugs and optimized combination regimens. The prospect of eradicating cervical cancer as the first malignancy to be eliminated is now within reach. In this review, we provide a comprehensive overview of the latest scientific insights, with a particular focus on precision managements for various stages of cervical disease, and explore future research directions in cervical cancer.

Round ligament suspension and vaginal purse‐string suture: Newly optimized techniques to prevent tumor spillage in laparoscopic radical trachelectomy for cervical cancer

AbstractAimThe purpose of this study was to investigate the surgical techniques and clinical feasibility of nonuterine manipulator and enclosed colpotomy to avoid cancer cell spillages in laparoscopic radical trachelectomy (LRT) for patients with early‐stage cervical cancer.MethodsWe performed the newly optimized surgical techniques of round ligament suspension and vaginal purse‐string suture in LRT in 12 patients with early‐stage cervical cancer from May 2019 to October 2020. Surgical information and postoperative results were recorded.ResultsAll 12 patients successfully underwent LRT with round ligament suspension and vaginal purse‐string suture, and no conversion to laparotomy was required. The median operation time was 268.5 min (range 200–320 min), including 5 min of round ligament suspension, and the median blood loss was 20 mL (range 5–50 mL). The median number of pelvic lymph nodes removed was 27 (range 19–35), and median amounts of paracervical tissue was 24 mm (range 21–26 mm) and vaginal tissue was 18 mm (range 16–26 mm). No intraoperative complication or serious postoperative complications were reported.ConclusionRound ligament suspension and vaginal purse‐string suture techniques are feasible and effective in LRT. They can replace uterine manipulator and unprotected colpotomy with satisfactory perioperative outcomes.