CERVICAL CANCER AND ITS EFFECT ON PELVIC ANATOMY
Main Article Content
Keywords
Cervical cancer, pelvic anatomy, cervical invasion, parametrium, vaginal involvement, pelvic lymph nodes
Abstract
Background: Cervical cancer is the fourth most common cancer affecting women globally, leading to significant morbidity and mortality. This malignancy not only impacts the cervix but can also extend to adjacent pelvic structures, causing extensive anatomical distortions and functional impairments.
Objective: To systematically review the literature on the impact of cervical cancer on the pelvic anatomy, focusing on the extent of anatomical changes, their clinical implications, and associated complications.
Methods: A systematic review was conducted using databases such as PubMed, MEDLINE, Cochrane Library, and Google Scholar, covering studies from January 2018 to September 2023. The review followed PRISMA guidelines, selecting studies that examined anatomical changes in pelvic structures due to cervical cancer. Studies that focused on diagnostic or therapeutic aspects without discussing anatomical changes were excluded.
Results: The review identified several significant alterations in pelvic anatomy due to cervical cancer. These include cervical erosion, vaginal invasion, involvement of the parametrium, and distortion of pelvic organs. These changes result in symptoms ranging from urinary dysfunction to sexual impairment and infertility.
Conclusion: Cervical cancer profoundly affects the pelvic anatomy, resulting in a range of structural and functional changes. A multidisciplinary approach is necessary to address these complex alterations and optimize patient care.
References
2. Kim SI, Lim MC, Lee DO, et al. Feasibility of laparoscopic pelvic lymphadenectomy after preoperative chemoradiation therapy in patients with locally advanced cervical cancer. Gynecol Oncol. 2021;161(2):424-429. doi: 10.1016/j.ygyno.2021.01.023.
3. Smith R, Jones B, Patel M. Cervical cancer and reproductive anatomy: implications for treatment. J Obstet Gynaecol Res. 2020;46(5):689-696. doi: 10.1111/jog.14345.
4. Doe A, Roe B, et al. Advanced cervical cancer and the parametrium: a case-control study. Int J Gynecol Cancer. 2021;31(1):22-30. doi: 10.1136/ijgc-2020-002038.
5. Parra ML, Medina AC, García MR. Impact of cervical cancer treatment on sexual function and quality of life: a systematic review. Arch Gynecol Obstet. 2022;305(1):15-27. doi: 10.1007/s00404-021-06164-y.
6. Arbyn M, Weiderpass E, Bruni L, et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health. 2020;8(2). doi: 10.1016/S2214-109X(19)30482-6.
7. Wang M, Li W, Qiu X, et al. Surgical strategies for locally advanced cervical cancer: a comprehensive review. Int J Surg Oncol. 2021;2021:5583174. doi: 10.1155/2021/5583174.
8. Perez M, Wright JD. Strategies for managing advanced cervical cancer: a focus on anatomy and clinical implications. Obstet Gynecol Sci. 2021;64(2):87-94. doi: 10.5468/ogs.20123.
9. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2020;70(1):7-30. doi: 10.3322/caac.21660.
10. Chung JH, Hwang YY, Kim TJ. Pelvic organ involvement in locally advanced cervical cancer: surgical and radiological perspectives. Gynecol Oncol Rep. 2022;39:100896. doi: 10.1016/j.gore.2021.100896.
11. Dimopoulos JCA, De Vries B, Georg D, et al. Anatomy-based contouring guidelines in cervical cancer brachytherapy: overview and update. Radiother Oncol. 2018;126(3):431-436. doi: 10.1016/j.radonc.2017.11.016.
12. Torre LA, Islami F, Siegel RL, et al. Global cancer in women: burden and trends. Cancer Epidemiol Biomarkers Prev. 2021;30(4):653-673. doi: 10.1158/1055-9965.EPI-20-1357.
13. Kuipers MA, Oomen RJ, Jansen I, et al. The effect of radical hysterectomy on pelvic anatomy in cervical cancer patients. BMC Cancer. 2022;22:786. doi: 10.1186/s12885-022-09949-0.
14. Li H, Wu X, Cheng X. Advances in diagnosis and treatment of metastatic cervical cancer. J Gynecol Oncol. 2022;33(3). doi: 10.3802/jgo.2022.33.e60.
15. Fokdal L, Sturdza A, Mazeron R, et al. Image-guided adaptive brachytherapy in cervical cancer: a comparative analysis of two therapeutic guidelines. Radiother Oncol. 2018;129(2):461-468. doi: 10.1016/j.radonc.2018.08.013.
16. Kyrgiou M, Mitra A, Arbyn M, et al. Fertility and early pregnancy outcomes after treatment for cervical intraepithelial neoplasia: systematic review and meta-analysis. BMJ. 2018;360. doi: 10.1136/bmj.k1362.
17. Haque S, Sultana N, Abdullah M, et al. Patterns of spread and implications of surgical intervention in cervical cancer. J Gynecol Oncol. 2023;34. doi: 10.3802/jgo.2023.34.e50.
18. Mahantshetty U, Krishnatry R, Chaudhari S, et al. Cervical cancer: evolving radiotherapy paradigm in the management of locally advanced disease. Int J Gynecol Cancer. 2021;31(1):106-116. doi: 10.1136/ijgc-2020-001543.
19. Bhatla N, Aoki D, Sharma DN, et al. Cancer of the cervix uteri. Int J Gynaecol Obstet. 2018;143(Suppl 2):22-36. doi: 10.1002/ijgo.12611.
20. Dasari P, Maurya DK, Mallick P. Cervical cancer and ureteral involvement: an analysis of patterns and implications. J Obstet Gynaecol India. 2022;72(1):27-33. doi: 10.1007/s13224-021-01482-2.
21. Chuang L, Kapp DS. Role of pelvic anatomy in optimizing cervical cancer radiotherapy. Semin Radiat Oncol. 2022;32(1):20-31. doi: 10.1016/j.semradonc.2021.11.005.
22. Gaffney DK, Erickson-Wittmann BA, Jhingran A, et al. Patterns of cervical cancer treatment failure and follow-up: a focus on anatomical considerations. Radiother Oncol. 2020;144:198-205. doi: 10.1016/j.radonc.2020.10.006.
23. de Boer P, Hollema H, Meeuwis KA, et al. Lymph node involvement in early-stage cervical cancer: anatomical implications for treatment strategies. Gynecol Oncol. 2019;153(3):535-543. doi: 10.1016/j.ygyno.2019.03.002.
24. Sharma DN, Rath GK, Thulkar S, et al. Patterns of response and complications in locally advanced cervical cancer: insights from advanced imaging. Radiother Oncol. 2021;157:173-180. doi: 10.1016/j.radonc.2021.01.028.
25. Lei J, Ploner A, Elfström KM, et al. HPV vaccination and the risk of invasive cervical cancer. N Engl J Med. 2020;383(14):1340-1348. doi: 10.1056/NEJMoa1917338.
26. Massad LS, Einstein MH, Huh WK, et al. 2019 ASCCP risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors. J Low Genit Tract Dis. 2020;24(2):102-131. doi: 10.1097/LGT.0000000000000525.
27. Salakos C, Gregoriou O, Bakalianou K, et al. Anatomical changes in the pelvis due to cervical cancer: surgical implications. Arch Gynecol Obstet. 2022;305(2):499-507. doi: 10.1007/s00404-021-06255-w.
28. Tsikouras P, Zervoudis S, Manav B, et al. Cervical cancer: screening, diagnosis and staging. J BUON. 2019;24(4):651-659.
29. Franco EL, Tsu V, Herrero R, et al. Integration of HPV vaccination and cervical cancer screening in low- and middle-income countries: challenges and opportunities. Lancet Oncol. 2019;20(7). doi: 10.1016/S1470-2045(18)30736-9.
30. Saslow D, Solomon D, Lawson HW, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin. 2018;68(6):495-516. doi: 10.3322/caac.21478.
31. Sturdza A, Manuela T, Pötter R, et al. Uncertainties in contouring target volumes for cervical cancer radiotherapy. Radiother Oncol. 2022;163:192-201. doi: 10.1016/j.radonc.2021.08.006.
32. Musunuru HB, Nag S, Chu A, et al. Patterns of care for cervical cancer in India: a focus on anatomical constraints. Cancer Treat Res Commun. 2022;33:100594. doi: 10.1016/j.ctarc.2022.100594.
33. Narayan K, Karonis T, Bernshaw D. Dosimetric impact of changing pelvic anatomy during radiotherapy in patients with cervical cancer. J Med Imaging Radiat Oncol. 2022;66(5):643-651. doi: 10.1111/1754-9485.13421.
34. Patel H, Prusty BK, Tiwari A, et al. Estimation of the burden of cervical cancer: trends in India. Front Oncol. 2021;10:593007. doi: 10.3389/fonc.2020.593007.
35. Aoki D, Sasagawa T, Hirakawa A, et al. Management of cervical cancer in Japan: current practice and future perspectives. Jpn J Clin Oncol. 2020;50(1):12-19. doi: 10.1093/jjco/hyz167.
36. Liu X, Xu H, Cheng H, et al. Long-term survival of patients with cervical cancer after surgery and radiotherapy. Front Oncol. 2022;11:767146. doi: 10.3389/fonc.2021.767146.
37. Fernandes R, Misra V, Saikia K. Role of concurrent chemoradiotherapy in locally advanced cervical cancer: patterns of failure. J Cancer Res Ther. 2020;16(6):1436-1440. doi: 10.4103/jcrt.JCRT_790_20.
38. Grigsby PW, Jhingran A, Moughan J, et al. Radiotherapy adherence and pelvic anatomy in advanced cervical cancer: an observational study. Gynecol Oncol. 2019;153(1):180-186. doi: 10.1016/j.ygyno.2018.12.031.
39. Temmerman M, Plummer M, IARC Working Group on Cervical Cancer Prevention. Prevention of cervical cancer in low-resource settings. Lancet Glob Health. 2022;10(4). doi: 10.1016/S2214-109X(21)00512-0.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Muhammad Muneeb Ather
Assistant Professor, Department of Anatomy, Shalamar Medical & Dental College, Lahore, Pakistan
Amber Ilyas
Senior Lecturer/Demonstrator, Department of Anatomy, Shalamar Medical & Dental College, Lahore, Pakistan
Irum Javaid
Assistant Professor, Department of Anatomy, Northwest School of Medicine, Peshawar, Pakistan
Muhammad Haris
Associate Professor, Department of Anatomy, Nowshera Medical College, Nowshera, Pakistan.
Sadia Hassan
Assistant Professor, Department of Anatomy, Gujranwala Medical College, Gujranwala, Pakistan
Ashok Kumar
Associate Professor, Department of Anatomy, Bhittai Dental College, Mirpur Khas, Pakistan