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The radical hysterectomy is the standard approach for the treatment of women with early cervical cancer. However, it has increasingly been recognized that a more individualized approach to treatment should be taken. In particular, careful pretreatment evaluation should reduce the number of women receiving adjuvant radiotherapy. Laparoscopic lymphadenectomy is an attractive technique that seems likely to reduce the use of dual modality therapy. The laparoscopic approach to the evaluation of lymph nodes in cervical cancer has also allowed the development of the fertility-preserving radical trachelectomy. Outcomes for women with early cervical cancer are generally good, and it therefore becomes increasingly relevant to develop methods of reducing long-term morbidity.

Regulatory T cells (Treg) are a sub-population of T cells that suppress self-reactivity and are implicated in immune tolerance towards malignant cells. Circulating Treg cells are increased in several cancers. In endometrial cancer Treg cells have been investigated only in tumour tissues and, in contrast to some other tumours, fewer Treg cells were reported in endometrial cancer compared with benign controls. Flow cytometry was used to determine the frequency of circulating Treg cells in women undergoing hysterectomy for either endometrial cancer (n = 24) or non- cancer-related conditions (n = 21). Circulating Treg cells were more abundant in women with cancer compared to those without (4.68% vs. 3.66%, p = 0.05, Mann-Whitney test). This relationship disappeared, however, when only data from post-menopausal women were included in the analysis. Mean Treg cell frequency was 4.65% in postmenopausal women with cancer (n = 23) and 4.73% in postmenopausal controls (n = 5) ( p = 0.9). In women without cancer we found that mean Treg cell frequency was higher in postmenopausal women (4.73%, n = 5) in comparison to premenopausal controls (3.33%, n = 16) ( p = 0.02). These results suggest that the increased proportion of Treg cells seen in endometrial cancer patients might be, at least in part, attributed to their postmenopausal status or age. [ABSTRACT FROM AUTHOR]

In this article, the authors describe modern surgical approaches for the treatment of endometrial cancer. It begins with the standard surgical approaches that include abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic and para-aortic lymphadenectomy. It then discusses the application of laparoscopic surgery in the management of both benign and malignant gynecological diseases. In addition, the article suggests the use of robotic hysterectomy in the treatment of cancer.