Introduction/Background During the last three decades, fertility preservation was established as a new treatment modality for young patients with early cervical cancer, less than 2 cm, using different surgical approaches and techniques such as vaginal or abdominal simple or radical trachelectomy, total laparoscopic or robotic trachelectomy even large conisation with laparoscopic lympadenectomy. A further goal for gynecological oncology is to consider a fertility-preserving approach in patients with bulky cervical cancer, without compromising the oncology outcome.
Methodology The thirty years old nulliparous with uterine sqamous cervix cancer FIGO stage IB2, 3 cm, underwent neoadjuvant chemotherapy, three cycles of Cisplatin and Ifosfamide dose dense regime according to Prague protocol. MRI was performed pre and post NACT treatment.
Results Due to complete pathologic response after three cycles of neoadjuvant chemotherapy conservative surgery was performed. The patient underwent laparoscopic pelvic lymphadenectomy, uterine cervix conisation and the cervical canal curettage.
The histopathology of specimen confirmed the complete response, with H SIL only. There was no need for adjuvant treatment. At the first follow up the length of uterine cervix was sufficient and PAP smear was normal. One year after surgery, patient is without disease. At the last control she was in sixteen weeks of gestation.
Conclusion Until now, small case control studies concluded that neoadjuvant chemotherapy followed by conservative fertility spare surgery in young patients with bulky cervical cancer who respond well to chemotherapy, is an acceptable approach. Still, more evaluation and data is needed for this group of patients before widespread use.
Disclosure Nothing to disclose.
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