{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T05:42:39Z","timestamp":1776663759786,"version":"3.51.2"},"reference-count":25,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T00:00:00Z","timestamp":1582070400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>There is an obvious prevalence of disparity in opinions concerning the technique of nerve-sparing radical hysterectomy and its application, despite agreement on the need to spare the pelvic autonomic nerve system during such a radical operation. Understanding the precise three-dimensional anatomy of paracolpium and its close anatomical relationship to the components of the pelvic autonomic nervous system is the key in performing the nerve-sparing radical hysterectomy. A total of 42 consecutive patients with primary cervical cancers, who were operated upon in our institution between January 2017 and June 2019, were analyzed, concerning surgical, urinary functional, and short-term oncologic outcomes. Two thirds of the patients had locally advanced tumors (T &gt; 40 mm or pT \u2265 IIA2) with a median tumor size of 44.1 mm. The nerve-sparing radical hysterectomy was combined with the complete recovery of bladder function in 90% of patients directly after surgery and in 97% of patients in the first 2 weeks. The recurrence rate in a median follow-up time of 18 months was 9.5%. The nerve-sparing radical hysterectomy approach, which depends on the comprehensive understanding of the precise entire anatomy of paracolpium, was found to be feasible and applicable, even in locally advanced tumors, with good functional results and convincing short-term oncologic outcomes.<\/jats:p>","DOI":"10.3390\/cancers12020483","type":"journal-article","created":{"date-parts":[[2020,2,24]],"date-time":"2020-02-24T03:33:43Z","timestamp":1582515223000},"page":"483","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Nerve Sparing Radical Hysterectomy: Short-Term Oncologic, Surgical, and Functional Outcomes"],"prefix":"10.3390","volume":"12","author":[{"given":"Mustafa Zelal","family":"Muallem","sequence":"first","affiliation":[{"name":"Department of Gynecology with Center for Oncological Surgery, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Virchow Campus Clinic, Charit\u00e9 Medical University, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Armbrust","sequence":"additional","affiliation":[{"name":"Department of Gynecology with Center for Oncological Surgery, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Virchow Campus Clinic, Charit\u00e9 Medical University, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rg","family":"Neymeyer","sequence":"additional","affiliation":[{"name":"Department of urology, Mitte Campus Clinic, Charit\u00e9 Medical University, 10117 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5029-7365","authenticated-orcid":false,"given":"Andrea","family":"Miranda","sequence":"additional","affiliation":[{"name":"Department of Gynecology with Center for Oncological Surgery, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Virchow Campus Clinic, Charit\u00e9 Medical University, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jumana","family":"Muallem","sequence":"additional","affiliation":[{"name":"Department of Gynecology with Center for Oncological Surgery, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Virchow Campus Clinic, Charit\u00e9 Medical University, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,2,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3406","DOI":"10.1245\/s10434-017-6031-z","article-title":"2017 update on the Querleu\u2013 Morrow classification of radical hysterectomy","volume":"24","author":"Querleu","year":"2017","journal-title":"Ann. Surg. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S1470-2045(08)70074-3","article-title":"Classification of radical hysterectomy","volume":"9","author":"Querleu","year":"2008","journal-title":"Lancet Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0020-7292(06)60030-1","article-title":"Carcinoma of the cervix uteri","volume":"95","author":"Quinn","year":"2006","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3033","DOI":"10.1245\/s10434-015-4377-7","article-title":"Oncological outcomes of nerve-sparing radical hysterectomy for cervical cancer: A systematic review","volume":"22","author":"Basaran","year":"2015","journal-title":"Ann. Surg. Oncol."},{"key":"ref_5","first-page":"5","article-title":"Nerve sparing radical hysterectomy in early stage cervical cancer. latest developments and review of the literature","volume":"36","author":"Kavallaris","year":"2015","journal-title":"Eur. J. Gynaecol. Oncol."},{"key":"ref_6","first-page":"53","article-title":"Feasibility of unilateral or bilateral nerve- sparing radical hysterectomy in patients with cervical cancer and evaluation of the post-surgery recovery of the bladder and rectal function","volume":"33","author":"Zhu","year":"2011","journal-title":"Zhonghua zhong liu za zhi"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1111\/IGC.0b013e3181f6381f","article-title":"Nerve sparing in radical surgery for early-stage cervical cancer: Yes we should!","volume":"20","author":"Gaarenstroom","year":"2010","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1136\/ijgc-2019-000410","article-title":"Nerve-sparing radical hysterectomy: Steps to standardize surgical technique","volume":"29","author":"Muallem","year":"2019","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1002\/ijgo.12749","article-title":"Revised FIGO staging for carcinoma of the cervix uteri","volume":"145","author":"Bhatla","year":"2019","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.1056\/NEJMoa1806395","article-title":"Minimally Invasive versus Abdominal Radical Hysterectomy for Cervical Cancer","volume":"379","author":"Ramirez","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_11","unstructured":"(2020, February 18). Available online: https:\/\/youtu.be\/dr675cXra9c."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.1136\/bmj.g1687","article-title":"Better reporting of interventions: Template for intervention description and replication (TIDieR) checklist and guide","volume":"348","author":"Hoffmann","year":"2014","journal-title":"BMJ"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.ygyno.2007.08.076","article-title":"Anatomic identification and functional outcomes of the nerve sparing Okabayashi radical hysterectomy","volume":"107","author":"Fujii","year":"2007","journal-title":"Gynecol. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey","volume":"240","author":"Dindo","year":"2004","journal-title":"Ann. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.ygyno.2006.07.041","article-title":"Precise anatomy of the vesico-uterine ligament for radical hysterectomy","volume":"104","author":"Fujii","year":"2007","journal-title":"Gynecol. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Cetina, L., Rivera, L., Hinojosa, J., Poitevin, A., Uribe, J., L\u00f3pez-Graniel, C., Cant\u00fa, D., Candelaria, M., de la Garza, J., and Due\u00f1as-Gonz\u00e1lez, A. (2006). Routine management of locally advanced cervical cancer with concurrent radiation and cisplatin. Five-year results. BMC Womens Health, 6.","DOI":"10.1186\/1472-6874-6-3"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1002\/cncr.27652","article-title":"The effect of treatment time in locally advanced cervical cancer in the era of concurrent chemoradiotherapy","volume":"119","author":"Song","year":"2013","journal-title":"Cancer"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1002\/ijgo.12611","article-title":"Cancer of the cervix uteri","volume":"143","author":"Bhatla","year":"2018","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"86","DOI":"10.5306\/wjco.v5.i2.86","article-title":"Different strategies of treat- ment for uterine cervical carcinoma stage IB2-IIB","volume":"5","author":"Minig","year":"2014","journal-title":"World J. Clin. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/S0140-6736(97)02250-2","article-title":"Randomised study of radical surgery versus radiotherapy for stage Ib-IIa cervical cancer","volume":"350","author":"Landoni","year":"1997","journal-title":"Lancet"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1200\/JCO.2000.18.8.1606","article-title":"Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early- stage cancer of the cervix","volume":"18","author":"Peters","year":"2000","journal-title":"J. Clin. Oncol."},{"key":"ref_22","first-page":"169","article-title":"The extended abdominal operation for carcinoma uteri (based on 500 operative cases)","volume":"66","author":"Wertheim","year":"1912","journal-title":"Am. J. Obstet. Dis. Women Child."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1002\/1097-0142(195609\/10)9:5<859::AID-CNCR2820090502>3.0.CO;2-T","article-title":"Obstetrical-gynecological eponyma: Ernst Wertheim and his operation for uterine cancer","volume":"9","author":"Speert","year":"1956","journal-title":"Cancer."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1111\/j.1464-410X.2007.07207.x","article-title":"Surgical anatomy of the ureter","volume":"100","year":"2007","journal-title":"BJU Int."},{"key":"ref_25","first-page":"439","article-title":"Vascularization of the ureter and Wertheim\u2019s operation. Effect of the type of ureteral vascularization on the occurrence of urinary complications after Wertheim\u2019s operation","volume":"11","author":"Triboulet","year":"1982","journal-title":"J. Gynecol. Obstet. Biol. Reprod. (Paris)"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/12\/2\/483\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T08:59:02Z","timestamp":1760173142000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/12\/2\/483"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,19]]},"references-count":25,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,2]]}},"alternative-id":["cancers12020483"],"URL":"https:\/\/doi.org\/10.3390\/cancers12020483","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,19]]}}}