Tailoring therapy in endometrial and cervical cancer

Gent, M.D.J.M. van (2017)

Doctoral Thesis

The thesis is on tailoring therapy in endometrial and cervical cancer. The standard treatment for endometrial cancer is a hysterectomy with bilateral salpingo-oophorectomy. This means definitive sterilisation for women in their fertile age. Treatment with progesterones is widely used, but the treatment needs evaluation and improvement since recurrences are frequent after response. This thesis gives an overview of the literature on this topic in chapter 2. Chapter 3 describes a study on molecular and histopathological changes is women on progesterone treatment to predict responders to therapy. Standard treatment of cervical cancer is a radical hysterectomy. Conventional radical hysterectomy damages nerves in het pelvic area and this results in therapy induced morbidity: urinary, bowel and sexual dysfunction. Chapter 4 is a systematic review and meta-analysis on nerve sparing radical hysterectomy versus non-nerve sparing radical hysterectomy, evaluating survival outcomes and quality of life. In chapter 5 the long term oncological outcomes of the conventional radical hysterectomy, the former Leiden nerve sparing hysterectomy and the nerve sparing Swift procedure, all performed at the LUMC are compared. In chapter 6 fertility and nerve sparing treatment are combined and the results of the abdominal trachelectomy performed at the LUMC is analysed. 

• Fertility sparing
• Nerve sparing
• Tailoring
• Endometrial cancer
• Cervical cancer
• QOL

• All authors: Gent, M.D.J.M. van
• Supervisor: Trimbos, J.M.B.Z.
• Co-supervisor: Kroon, C.D. de; Kagie, M.J.
• Committee: Jansen, F.W.; Amant, F.; Mourits, M.J.E.; Hazelbag, H.M.
• Qualification: Doctor (dr.)
• Awarding Institution: Gynaecologische oncologie, Medicine, Leiden University
• Date: 2017-06-20
• ISBN (print): 9789402806502
• Sponsorship: Haaglanden Medisch Centrum, Afdeling gynaecologie, LUMC, Toshiba, Chipsoft