Cervical Cancer and Fertility-Sparing Treatment

Radical hysterectomy with pelvic node dissection is the standard treatment for early-stage cervical cancer. However, the latter can be diagnosed at a young age when patients have not yet achieved their pregnancy plans. Dargent first described the vaginal radical trachelectomy for patients with tumor...

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Bibliographic Details
Main Authors: François Zaccarini, Claire Sanson, Amandine Maulard, Stéphanie Schérier, Alexandra Leary, Patricia Pautier, Cyrus Chargari, Catherine Genestie, Sébastien Gouy, Philippe Morice
Format: article
Language:EN
Published: MDPI AG 2021
Subjects:
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Online Access:https://doaj.org/article/5a3562a2667249d8b9a3cab9a5b97f74
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Summary:Radical hysterectomy with pelvic node dissection is the standard treatment for early-stage cervical cancer. However, the latter can be diagnosed at a young age when patients have not yet achieved their pregnancy plans. Dargent first described the vaginal radical trachelectomy for patients with tumors <2 cm. It has since been described a population of low risk of recurrence: patients with tumors <2 cm, without deep stromal infiltration, without lymphovascular invasion (LVSI), and with negative lymph nodes. These patients can benefit from a less radical surgery such as conization or simple trachelectomy with the evaluation of the pelvic node status. Tumors larger than 2 cm have a higher risk of recurrence and their treatment is a challenge. There are currently two options for these patients: abdominal radical trachelectomy or neoadjuvant chemotherapy (NACT), followed by fertility-sparing surgery. All patients who wish to preserve their fertility must be referred to expert centers.