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Bulky Early-Stage Cervical Cancer (2-4 cm Lesions): Upfront Radical Trachelectomy or Neoadjuvant Chemotherapy Followed by Fertility-Preserving Surgery
  1. Marie Plante, MD
  1. Gynecologic Oncology Division, Centre Hospitalier Universitaire de Québec, L’Hôtel-Dieu de Québec, Laval University, Quebec City, Quebec, Canada.
  1. Address correspondence and reprint requests to Marie Plante, MD, L’Hôtel-Dieu de Québec, Gynecologic Oncology Service, 11 Côte du Palais, Quebec City, Quebec, Canada G1R-2J6. E-mail: marie.plante{at}


Abstract Radical trachelectomy is now recognized as a valid treatment option for young women with early-stage cervical cancer with lesions measuring less than 2 cm. However, for women with bulky lesions measuring greater than 2cm, few data are available in the literature to guide management. There are currently 2 options available: either upfront radical trachelectomy or neoadjuvant chemotherapy followed by fertility-preserving surgery. Overall, both options offer very good oncologic outcome; however, the rate of fertility preservation and obstetrical outcome seem superior after neoadjuvant chemotherapy. Advantages and disadvantages of both options are discussed and a thorough literature review is provided. Issues to be further studied are also outlined.

  • Fertility preservation
  • Bulky early-stage cervical cancer
  • Neoadjuvant chemotherapy
  • Fertility-preserving surgery
  • Abdominal radical trachelectomy

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  • The author declares no conflict of interest.