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Standard surgical treatment of cervical cancer including nerve and fertility preserving as well as minimally invasive modifications is based on surgical anatomy empirically deduced from the adult organism and on a model of progressive radial tumor spread preferring a transverse paracervical plane towards the lateral pelvic wall. However, these principles are not compatible with pelvic anatomy founded on embryonic development and with the permeation of cervical cancer observed in MRI and histopathologic investigations. These discrepancies may explain the relatively unfavorable clinical results and the frequent necessity of adjuvant radiation. The theory of local tumor spread within embryologically derived permissive compartments is fully in line with the macroscopic and microscopic growth pattern of cervical cancer. The surgical translation of this concept into compartment resection performed as total mesometrial resection (TMMR) holds a great potential to improve the treatment results for early cervical cancer, particularly for those patients with poor prognostic factors.  相似文献   

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