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1124 Outcomes of fertility-sparing surgery compared to more radical surgery for patients with clinical early stage cervical cancer: a nationwide cohort study over 20 years
  1. Janneke Wolswinkel,
  2. Mieke Ten Eikelder and
  3. Petra Zusterzeel
  1. Radboud University Medical Center, Nijmegen, The Netherlands


Introduction/Background Fertility-sparing surgery (FSS) is offered to young women with clinical early-stage cervical cancer who wish preserve their fertility. However, when adjuvant treatment is needed, there is a tension between fertility and survival outcomes.

Methodology All patients under the age of 45 years diagnosed with clinical early-stage cervical cancer between 2000 and 2022 were included in a nationwide retrospective cohort study. We compared overall survival and disease free survival of patients either undergoing FSS or undergoing more radical surgery. Patients with preoperative stage IA1, IA2, IB1, IB2 (FIGO 2018), who underwent FSS, i.e., cone biopsy, simple trachelectomy or radical trachelectomy with lymph node assessment, were matched 1:2 for preoperative stage, LVSI and histology with patients who underwent hysterectomy or radical hysterectomy with lymph node assessment.

Results In the study period 505 patients received FSS and were compared with 1010 controls. 7.3% (n=37) had high risk factors that needed adjuvant (chemo)radiation after FSS: 3.6% lymph node metastasis, 3.1% positive surgical margin and 0.6% parametrial invasion; fertility was impaired after adjuvant treatment in all (n=37) of them. 7.7% (n= 39) developed recurrence of disease, 4.4% died of disease after FSS. DFS and OS of both intervention and control group will be calculated and presented.

Conclusion Fertility preservation could be achieved in most women treated with FSS in low-risk cervical cancer. Low incidence of parametrial involvement might justify waiving parametrectomy in tumours < 2 cm.

Disclosures None.

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