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Minimizing Fertility-sparing Treatment for Low Volume Early Stage Cervical Cancer; Is Less the (R)Evolution?
Anticancer Res. 2020 Jul; 40(7):3651-3658.AR

Abstract

BACKGROUND/AIM

The aim of this study was to conduct a review on less radical fertility-sparing surgical treatment for early-stage cervical cancer.

MATERIALS AND METHODS

We conducted a Medline search from 2014 to 2018 regarding less radical fertility-sparing techniques, such as simple trachelectomy or cervical conization, with pelvic lymphadenectomy. We also assessed the impact of the removal of the parametrium on the obstetric and oncologic outcome, in women who desire to preserve their fertility.

RESULTS

We analyzed studies about cervical conization and simple trachelectomy, together with pelvic lymphadenectomy in early-stage cervical cancer. We also assessed the importance of parametrial involvement in reducing morbidity, without jeopardizing the oncologic outcome of these patients. Studies demonstrate that in tumors ≤2 cm, without lymphovascular Space Invasion and without evidence of parametrial involvement, a less radical fertility-sparing surgical approach could increase pregnancy rates and have a positive effect on the quality of life of these patients.

CONCLUSION

Standard fertility-sparing treatment for early-stage cervical cancer is still radical trachelectomy with pelvic lymphadenectomy. However, studies suggest that the omission of parametrectomy is a feasible and safe option. Simple trachelectomy or cervical conization, both combined with pelvic lymphadenectomy are acceptable approaches in a selected group of patients with early-stage cervical cancer.

Authors+Show Affiliations

Unit of Gynecologic Oncology, 1 Department of Obstetrics & Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece ch.theofanakis@gmail.com.Unit of Gynecologic Oncology, 1 Department of Obstetrics & Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece.Unit of Gynecologic Oncology, 1 Department of Obstetrics & Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece.Unit of Gynecologic Oncology, 1 Department of Obstetrics & Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece.Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, U.K.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32620604

Citation

Theofanakis, Charalampos, et al. "Minimizing Fertility-sparing Treatment for Low Volume Early Stage Cervical Cancer; Is Less the (R)Evolution?" Anticancer Research, vol. 40, no. 7, 2020, pp. 3651-3658.
Theofanakis C, Haidopoulos D, Thomakos N, et al. Minimizing Fertility-sparing Treatment for Low Volume Early Stage Cervical Cancer; Is Less the (R)Evolution? Anticancer Res. 2020;40(7):3651-3658.
Theofanakis, C., Haidopoulos, D., Thomakos, N., Rodolakis, A., & Fotopoulou, C. (2020). Minimizing Fertility-sparing Treatment for Low Volume Early Stage Cervical Cancer; Is Less the (R)Evolution? Anticancer Research, 40(7), 3651-3658. https://doi.org/10.21873/anticanres.14354
Theofanakis C, et al. Minimizing Fertility-sparing Treatment for Low Volume Early Stage Cervical Cancer; Is Less the (R)Evolution. Anticancer Res. 2020;40(7):3651-3658. PubMed PMID: 32620604.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Minimizing Fertility-sparing Treatment for Low Volume Early Stage Cervical Cancer; Is Less the (R)Evolution? AU - Theofanakis,Charalampos, AU - Haidopoulos,Dimitrios, AU - Thomakos,Nikolaos, AU - Rodolakis,Alexandros, AU - Fotopoulou,Christina, PY - 2020/05/27/received PY - 2020/06/16/revised PY - 2020/06/19/accepted PY - 2020/7/5/entrez PY - 2020/7/6/pubmed PY - 2020/7/14/medline KW - Cervical cancer KW - conization KW - parametrial involvement KW - pelvic lymphadenectomy KW - review KW - simple trachelectomy KW - small volume SP - 3651 EP - 3658 JF - Anticancer research JO - Anticancer Res. VL - 40 IS - 7 N2 - BACKGROUND/AIM: The aim of this study was to conduct a review on less radical fertility-sparing surgical treatment for early-stage cervical cancer. MATERIALS AND METHODS: We conducted a Medline search from 2014 to 2018 regarding less radical fertility-sparing techniques, such as simple trachelectomy or cervical conization, with pelvic lymphadenectomy. We also assessed the impact of the removal of the parametrium on the obstetric and oncologic outcome, in women who desire to preserve their fertility. RESULTS: We analyzed studies about cervical conization and simple trachelectomy, together with pelvic lymphadenectomy in early-stage cervical cancer. We also assessed the importance of parametrial involvement in reducing morbidity, without jeopardizing the oncologic outcome of these patients. Studies demonstrate that in tumors ≤2 cm, without lymphovascular Space Invasion and without evidence of parametrial involvement, a less radical fertility-sparing surgical approach could increase pregnancy rates and have a positive effect on the quality of life of these patients. CONCLUSION: Standard fertility-sparing treatment for early-stage cervical cancer is still radical trachelectomy with pelvic lymphadenectomy. However, studies suggest that the omission of parametrectomy is a feasible and safe option. Simple trachelectomy or cervical conization, both combined with pelvic lymphadenectomy are acceptable approaches in a selected group of patients with early-stage cervical cancer. SN - 1791-7530 UR - https://www.unboundmedicine.com/medline/citation/32620604/Minimizing_Fertility-sparing_Treatment_for_Low_Volume_Early_Stage_Cervical_Cancer L2 - http://ar.iiarjournals.org/cgi/pmidlookup?view=long&pmid=32620604 DB - PRIME DP - Unbound Medicine ER -