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The hypogastric nerve is dissected free from the uterosacral ligaments and the surrounding tissue, permitting a far more radical resection of the entire uterosacral ligaments and rectal pillars (Fig. 2 right).
Whether they directly compare to local excision or more radical resection has not been proven.
Once definitive histopathology is obtained, a further, more radical resection may have to be considered.
The other strategy aims at improving the cure rate by performing a more radical resection.
The introduction of fluorescence-guided resection allows a better identification of tumor tissue and its more radical resection.
Transhiatal with mediastinal lymphadenectomy plus TG comprises a more radical resection margin that prevents residual disease at the esophageal margin and allows removal of all the perigastric and peridiaphragmatic hiatus lymph nodes.
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Two European level I randomized controlled trials refute Asian lesser level evidence promoting more radical resections.
Neoadjuvant treatment increased the radical resection rate; in patients who received radiotherapy (either full course or re-irradiation) or radiochemotherapy significantly more radical resections were performed than in patients who did not.
As an alternative or in addition to more radical esophageal resections, many centers around the United States use neoadjuvant chemoradiation (CRT) for multimodality therapy for locally advanced (stage IIa IVa) esophageal cancer, although the trials supporting this approach have many limitations.
Also, mutated IDH1 has been reported as a marker indicating that more radical surgical glioma resection may be of benefit for the patient [ 14].
More radical approaches, including cyst resections, atypical resections, and lobectomies, have been undertaken, and the recurrence rates were zero.
More suggestions(15)
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