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Ovarian Cancer Diagnosis and Treatment / Endometrial and Cervical Cancer Treatments · Journal article
World Journal of Surgical Oncology · September 7, 2026
A consensus or society position rather than new primary data.
This narrative review consolidates current evidence on the evolving role of open abdominal surgery in gynecological malignancies, concluding that open surgery remains indispensable but is being refined by biomarkers and integrated into multimodal, biology-adapted treatment strategies. Rather than being replaced by minimally invasive techniques, open surgery is repositioned as a specialized component for selected patients, particularly in advanced-stage disease requiring cytoreduction. The review reflects contemporary practice guidelines across cervical, endometrial, and ovarian cancers, emphasizing that patient selection in experienced centers remains the critical determinant of outcomes.
Narrative review. Literature on gynecological malignancies (cervical, endometrial, ovarian, tubal, primary peritoneal cancer) treated with open, laparoscopic, or robotic surgery in combination with systemic and immunotherapy.. Intervention: Open abdominal surgical procedures (radical hysterectomy, cytoreductive surgery, pelvic exenteration) combined with systemic therapies and immunotherapy. Compared with: Minimally invasive approaches (laparoscopic and robotic surgery) and precision oncology strategies.
Open radical abdominal hysterectomy confirmed as standard of care for cervical cancer internationally Minimally invasive approaches established for early-stage endometrial cancer; laparotomy remains gold standard for advanced disease requiring cytoreductive surgery Open cytoreductive surgery with goal of macroscopically complete resection remains guideline-recommended for ovarian, tubal, and primary peritoneal carcinoma
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
Clinicians and multidisciplinary teams should recognize that open abdominal surgery retains a defined and essential role in gynecological oncology, particularly for advanced-stage disease and complete cytoreduction, rather than being supplanted by minimally invasive techniques. Treatment decisions should be individualized based on disease stage, biology, and institutional expertise.
A narrative review synthesizing current literature on surgical approaches in gynecological malignancies, offering expert consensus on the continuing role of open surgery alongside modern alternatives rather than reporting new empirical data.
As stated by the source record.
Clinicians and multidisciplinary teams should recognize that open abdominal surgery retains a defined and essential role in gynecological oncology, particularly for advanced-stage disease and complete cytoreduction, rather than being supplanted by minimally invasive techniques. Treatment decisions should be individualized based on disease stage, biology, and institutional expertise.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
What is missing. This record has no reported figures. That is a gap in the analysis, not a judgement about the study.
Abstract Background Oncological surgery is undergoing profound transformation driven by advances in systemic therapy, immunotherapy, and minimally invasive techniques. This narrative review examines whether open abdominal surgery retains clinical relevance in gynecological malignancies or has been superseded by modern alternatives. Methods A literature search was conducted in PubMed combining terms related to gynecological malignancies, abdominal surgical procedures (open, laparoscopic, robotic, cytoreduction, pelvic exenteration), and personalized systemic therapies. Original articles, reviews, and guidelines in German and English were included. Two independent reviewers screened titles, abstracts, and full texts, extracting data on study design, interventions, and clinical endpoints (R0 resection, morbidity, progression-free and overall survival). Results For cervical cancer, open radical abdominal hysterectomy as the standard of care was internationally confirmed. In endometrial cancer, minimally invasive approaches are established for early-stage disease, while laparotomy remains the gold standard in advanced stages requiring cytoreductive surgery. For ovarian, tubal, and primary peritoneal carcinoma, open cytoreductive surgery with the goal of macroscopically complete resection remains guideline recommended. Emerging biomarkers such as circulating tumor DNA may further refine patient selection and surgical decision-making. Conclusion Open abdominal surgery remains indispensable in gynecological oncology. Rather than being replaced, it is evolving into a specialized, biology-adapted component of multimodal treatment strategies. Surgical indications are becoming less frequent but more complex and individualized. Patient selection in experienced centers remains the decisive factor.
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