Introduction/Background In this prospective study, we report our experience in fertility-sparing surgery (FSS) for patients with early-stage cervical cancer (eCC) comparing the oncological outcomes with those who underwent radical surgery.

Methodology Consecutive patients who underwent FSS were prospectively enrolled. The patients carried out large cervical conization and nodal evaluation. Patients treated with radical hysterectomy and nodal evaluation were also enrolled. The oncological outcomes of the two groups were assessed with a propensity score analyses with inverse probability treatment weighting (IPTW).

Results Overall 126 were enrolled in the study, after IPTW matching, 33 patients in the FSS case group and 55 patients in the RH control group were analyzed. Sentinel node mapping was carried out in 23 (42,6%) patients. 10 patients abandoned FSS route because of nodal involvement, margin positive or because patients requested definitive treatment. Among the patients who underwent FSS, 4 (7,4%) patients relapsed in the cervix and underwent radical surgery. The patients who attempted to conceive were 59,2%. Preoperative covariates selected to define the probability of having either FSS or RH were well balanced using IPTW. Pathological features were similar between the groups including grading, histotype, FIGO stage, and LVSI. After a median follow-up of 38,8 months there were no statistically significant differences in PFS and OS between the two groups before and after IPTW adjustment.

Conclusion FSS based on large conization and laparoscopic lymph-node evaluation, following strict inclusion criteria, may be considered safe for eCC patients. Recent studies that suggest a less radical surgery, improving the quality of life without compromising oncological safety, are in line with our findings.

Disclosures ES has received honoraria from Ibsa and Gedeon Richter. He also handles grants of research from Ferring and Ibsa (not for the present study).

All other authors have no conflict of interest or funding to declare.