Oncological outcomes after fertility-sparing surgery for cervical cancer: a systematic review

Summary Fertility preservation in young patients with cervical cancer is suitable only for patients with good prognostic factors and disease amenable to surgery without adjuvant therapy. Consequently, it is only offered to patients with early-stage disease (stage IB tumours 2 cm) and lymphovascular...

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Bibliographic Details
Published in:The lancet oncology 2016-06, Vol.17 (6), p.e240-e253
Main Authors: Bentivegna, Enrica, MD, Gouy, Sebastien, MD, Maulard, Amandine, MD, Chargari, Cyrus, MD, Leary, Alexandra, MD, Morice, Philippe, Prof
Format: Article
Language:English
Subjects:
Abdomen
Cancer therapies
Cervical cancer
Chemotherapy
Dissection
Female
Fertility
Fertility Preservation
Gynecologic Surgical Procedures - methods
Hematology, Oncology and Palliative Medicine
Humans
Infertility, Female - prevention & control
Morbidity
Postoperative Complications - prevention & control
Surgery
Treatment Outcome
Tumors
Uterine Cervical Neoplasms - pathology
Uterine Cervical Neoplasms - surgery
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Summary:Summary Fertility preservation in young patients with cervical cancer is suitable only for patients with good prognostic factors and disease amenable to surgery without adjuvant therapy. Consequently, it is only offered to patients with early-stage disease (stage IB tumours 2 cm) and lymphovascular space invasion status are two main factors to determine the best fertility-sparing surgical technique. In this systematic Review, we assess six different techniques that are available to preserve fertility (Dargent's procedure, simple trachelectomy or cone resection, neoadjuvant chemotherapy with conservative surgery, and laparotomic, laparoscopic and robot-assisted abdominal radical trachelectomy). The choice between the six different fertility preservation techniques should be based on the experience of the team, discussion with the patient or couple, and, above all, objective oncological data to balance the best chance for cure with optimum fertility results for each procedure.
ISSN:1470-2045
1474-5488
DOI:10.1016/S1470-2045(16)30032-8