Article Text

Download PDFPDF

PR015/#791  Measuring the risk-benefit of obstetric and oncologic aspects of fertility-sparing surgery among early cervical cancer ≥2 cm: implications captured in systematic review and meta-analysis
  1. Irwin Lumbanraja,
  2. Muhammad Yaznil and
  3. Naufal Firsty
  1. Universitas Sumatera Utara, Obstetrics and Gynecology, Medan, Indonesia


Introduction Composing approaches to early cervical cancer (CC ≥2 cm in tumor size) in fertile years implicates around the preservation of the reproductive function; on whether the following intervention (i.e., operative procedures with/without neoadjuvant chemotherapy (NACT)) offer acceptable child-bearing potential within an estimable risk of cancer recurrence? This study aims to measure the obstetric and oncologic outcomes among woman with early CC ≥2 cm treated by fertility-sparing management.

Methods This study is in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) to review cohorts from the last decade, focused on fertility-sparing intervention among woman with CC ≥2 cm. The obstetric outcome is consisted by pregnancy rate (PR), living-birth rate (LBR), and pre-term rate (PtR); supported by the recurrence rate (RR) and moderated by NACT status. The statistical analyses were performed with random-effect model (REM) in Comprehensive Meta Analysis (CMA) version 3.0.

Results We included 16 studies encompassed by 499 individuals to the final analysis. The estimated overall obstetrical outcomes were 32.4%, 58.5%, and 37.1%, respectively. Prior NACT administration proved to increase the outcomes e.g., PR (47.6% vs. 22.5%) and LBR (73.1% vs. 35.7%); though the findings were not observed on PtR (37.1% vs. 33.3%). Interestingly, we also found that the RR was higher among NACT+ populations (12.1%) compared to its control (5.1%).

Conclusion/Implications Fertility-sparing treatment may substantially affect the obstetric outcomes among women with CC ≥2 cm which can be improved by NACT administration, though our study revealed a possibility of worse oncologic outcomes among NACT-receiving individuals.

Statistics from

Request Permissions

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.