RESUMEN
Cancer treatment-induced bone loss is a known side effect of cancer therapy that increases the risk of osteoporosis and bone fracture. Women with gynecologic cancer are at increased risk of bone loss secondary to the combined effect of oophorectomy and adjuvant therapies. Data regarding bone loss in women with gynecologic cancers are overall lacking compared to other cancer populations. Consequently, guidelines for osteoporosis screening in women with cancer are largely based on data generated among non-gynecologic cancer survivors. This article reviews current available data of bone health in women with gynecologic cancer, summarizes best-available guidelines for screening for osteoporosis in women with cancer, and provides guidance for osteoporosis screening in women with gynecologic cancers based on best available evidence.
Asunto(s)
Densidad Ósea/fisiología , Supervivientes de Cáncer/estadística & datos numéricos , Neoplasias de los Genitales Femeninos/terapia , Tamizaje Masivo/normas , Osteoporosis/diagnóstico , Absorciometría de Fotón , Antineoplásicos Hormonales/efectos adversos , Densidad Ósea/efectos de los fármacos , Densidad Ósea/efectos de la radiación , Quimioterapia Adyuvante/efectos adversos , Quimioterapia Adyuvante/métodos , Medicina Basada en la Evidencia/normas , Femenino , Neoplasias de los Genitales Femeninos/complicaciones , Neoplasias de los Genitales Femeninos/mortalidad , Humanos , Menopausia/efectos de los fármacos , Menopausia/metabolismo , Menopausia/efectos de la radiación , Osteoporosis/epidemiología , Osteoporosis/etiología , Osteoporosis/metabolismo , Ovario/efectos de los fármacos , Ovario/metabolismo , Ovario/efectos de la radiación , Ovario/cirugía , Guías de Práctica Clínica como Asunto , Radioterapia Adyuvante/efectos adversos , Factores de Riesgo , Salpingooforectomía/efectos adversos , SupervivenciaRESUMEN
OBJECTIVE: To describe the surgical technique of uterine artery sparing robotic assisted radical trachelectomy (AS-RRT) for early stage cervical cancer. METHODS: We used our experience with AS-RRT performed at the University of Wisconsin-Carbone Comprehensive Cancer Center, USA, to present a detailed description of the surgical technique. RESULTS: The report details, step-by-step, our innovative surgical technique, supported by photos and illustrations. We also discuss potential difficulties with the surgical technique and offer solutions. CONCLUSION: Technically, the surgery is feasible and could be performed by any gynecologic oncologist who is skilled in radical pelvic surgery and the robotic system. The long-term obstetric and oncologic outcome of this technique would be expected to match the outcome of the other radical trachelectomy techniques in the published literature, but is yet to be fully elucidated.