宫颈癌一直是并且仍然是一个主要的全球健康问题和一个重大的治疗挑战，手术干预在过去一个世纪中发挥了关键作用。在不存在高危因素的早期阶段（I/A2-II/B），手术和放疗的疗效被认为是等效的，但具有不同的（特定于治疗方式的）并发症和生活质量后果。疾病早期（盆腔淋巴结阳性）和晚期（宫旁和/或手术切缘肿瘤受累）的负面预后因素预示着良好预期寿命的前景恶化。在这些高风险病例中，当放疗或放化疗禁忌时，我们研究了比传统根治性子宫切除术更彻底的手术方法的潜在作用。二十五年前，布达佩斯引入了一种用于治疗高危宫颈癌患者的超根治手术。该手术在匈牙利布达佩斯被命名为横向扩展宫旁切除术（LEP）。手术目的是完全去除骨盆的纤维脂肪组织内容物，其中包含淋巴管、淋巴结和受肿瘤影响的骨盆侧壁结构。我们启动了对宫旁和/或淋巴结肿瘤阳性早期病例的主要治疗以及放疗后盆腔侧壁复发肿瘤的二线手术治疗的观察性研究。我们的观察性研究的有希望的结果表明，值得启动前瞻性随机试验，以阐明这种治疗方式在预后不良的患者队列中的潜力。© 2024。外科肿瘤学会。

Cervical cancer has been and still is a major global health problem and a major treatment challenge for which surgical interventions have played a key role throughout the past century. In early stages (I/A2-II/B), where high-risk factors are not present, the efficacy of surgical and radiotherapy treatment has been considered equivalent with different (treatment modality specific) complications and quality of life consequences. Negative prognostic factors in early stages of the disease (pelvic lymph-node positivity) and in more advanced stages (parametrial and/or surgical margins' tumor involvement) forecast the deterioration of outlooks for good life expectancy. In these high-risk cases, when radio- or chemoradiotherapy is contraindicated, we investigated the potential role of a more radical surgical approach than the traditional radical hysterectomy. Twenty-five years ago, a hyperradical surgical procedure for the treatment of high-risk cervical cancer patients was introduced in Budapest. The procedure was named as laterally extended parametrectomy (LEP) in Budapest Hungary. The surgical intention was the complete removal of the fibro-fatty tissue content of the pelvis, which contains the lymphatic vessels, lymph nodes, and tumor-affected pelvic side wall structures. We initiated observational studies on the primary treatment in parametrium and/or lymph-node tumor-positive early-stage cases and on second-line surgical therapy of pelvic side wall recurrent tumors following radiotherapy. Promising results of our observational studies propose that prospective randomized trials are worth to be initiated to clarify the potential of this treatment modality in this poor prognosis cohort of patients.© 2024. Society of Surgical Oncology.