The management of most human cancers involves multimodal therapy, and this is especially true for female genital malignancies. Although some early gynecologic cancers can be eradicated by surgery alone, and chemotherapy as a single modality can often cure gestational trophoblastic malignancies, the optimal treatment for the majority of gynecologic malignancies requires surgery combined with chemotherapy and/or irradiation.
In this chapter, surgery is discussed both as a separate discipline and as an integral part of multimodal therapeutic planning. Although specific operations and relatively new surgical techniques are described for some disease sites, many procedures are addressed more completely in surgical texts and atlases to which the reader is referred (1-3).
The role of surgical intervention in the treatment of gynecologic cancers is addressed herein with a more philosophic approach than would be taken in a surgical atlas. However, select illustrations and tips are included that have enabled us to approach various radical procedures more confidently and safely.
The major goal of this chapter is to give the reader an appreciation and understanding of the surgical principles of the subspecialty of gynecologic oncology.