Introduction/Background To evaluate oncological and obstetrical outcomes of early stage cervical cancer patients who attempted a conservative management to retain their childbearing potential.
Methodology Data of women (aged <40 years) who attempted a fertility sparing treatment for FIGO stage IA1-LVSI+, IB1 and IB2 cervical cancer were prospectively collected. All patients underwent cervical conization/s and laparoscopic nodal evaluation (pelvic lymphadenectomy/sentinel node mapping). Oncological and obstetrical outcomes were assessed.
Results Overall, 44 patients met the inclusion criteria. Forty-one (93.2%) women were nulliparous. There were: 3 (6.8%) IA1-LVSI+; 11 (25%) IA2; 25 (56.8%) IB1; 5 (11.4%) IB2 cervical cancers, according to 2018 FIGO stage. Hystological type were: 25 (56.8%) squamous carcinoma; 18 (40.9%) adenocarcinoma and 1 (2.3%) adenosquamous carcinoma. Pelvic lymphadenectomy was performed in 31 (70.4%) cases, while 13 (29.6%) patients had only sentinel node mapping. Four (9.1%) patients received neoadjuvant chemotherapy. In 7 (15.9%) patients conservative treatment was discontinued (5 nodal involvement, 2 no response to chemotherapy) and 2 (4.5%) patients asked for definitive treatment (hysterectomy) following a negative nodal evaluation.
Among 35 (79.6%) patients who retained their childbearing potential: 17 (48.6%) had a second conization; 2 (5.7%) relapsed and underwent definitive treatment. After a median follow-up of 51 (range 1–184) months no deaths were reported. Twenty-two (66.7%) women attempted to conceive. There were 13 natural pregnancies among 12 (54.5%) women who got pregnant. Live birth rate was 76.9%: nine (69.2%) term and one (7.7%) preterm (at 32w) deliveries. Two (15.4%) miscarriage (1st and 2nd trimester) and one (7.7%) termination of pregnancy for medical reasons were recorded.
Conclusion Conization plus laparoscopic nodal evaluation is an ultraconservative but feasible option in the setting of fertility-sparing treatment for early-stage cervical cancer patients.
Disclosures The authors declare that there are no conflicts of interest.
No funding sources supported this investigation.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.