scholarly journals Surgical and pathologic outcomes of fertility-sparing radical abdominal trachelectomy for FIGO stage IB1 cervical cancer

2008 ◽  
Vol 111 (2) ◽  
pp. 261-264 ◽  
Author(s):  
Nadeem R. Abu-Rustum ◽  
Nikki Neubauer ◽  
Yukio Sonoda ◽  
Kay J. Park ◽  
Mary Gemignani ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Figo Stage ◽  
Fertility Sparing

scholarly journals Fertility sparing surgery following neoadjuvant chemotherapy of cervical cancer figo stage IB2 - case report

2019 ◽  
Author(s):  
Aljosa Mandic ◽  
Miona Davidovic-Grigoraki ◽  
Bojana Gutic ◽  
Natasa Prvulovic Bunovic ◽  
Nenad Solajic ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Case Report ◽  
Neoadjuvant Chemotherapy ◽  
Figo Stage ◽  
Fertility Sparing Surgery ◽  
Fertility Sparing

The complex relationship between infertility and female genital tract cancer: A review

2021 ◽  
pp. 039156032110364
Author(s):  
Familiari Alessandra ◽  
Gallitelli Vitalba ◽  
Biscione Antonella ◽  
Di Marco Giulia ◽  
Conte Carmine ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cervical Cancer ◽  
Gynecological Cancer ◽  
Figo Stage ◽  
Female Infertility ◽  
Female Fertility ◽  
Reproductive Age ◽  
Increased Risk ◽  
Fertility Sparing ◽  
Infertility Treatments

Introduction: The link between female infertility and gynecological cancer has always been a debated and challenging topic. Although cervical cancer has the worst impact on female fertility, as it is usually diagnosed in patients of reproductive age, endometrial and ovarian cancer are also diagnosed and treated often in relatively younger patients in which fertility preservation is a relevant issue. The aim of this review is to highlight the correlation between therapy for female infertility and the developing cancer’s risk and to describe the fertility sparing treatments in gynecological oncology. Material and methods: A systematic review of the literature through the main scientific search engines (PubMed and Google Scholar) was performed. We selected the most relevant articles based on the largest case series and the latest updates. All selected documents have been listed in the references. Results: Fifty-six relevant articles published between 1996 and 2019 were identified. Results from the available evidence report no significant increased risk of endometrial, cervical, and ovarian cancer in patients having infertility treatments. In young patients diagnosed with gynecological cancer, preservation of fertility is a personalized choice depending on several factors (type, stage, age and desire to conceive, safety of the treatment, and feasibility of fertility sparing surgery). For ovarian cancer FIGO stage IA G1, IA G2 (grade), and IC G1; for endometrial adenocarcinoma grade 1 with no lymphovascular space invasion (LVSI) or myometrial invasion and for early-stage cervical cancer (FIGO stage 2018: IA1-IB1), fertility sparing treatment is possible. The role of fertility sparing treatment with the increase of personalization of therapies therapy is always a theme of discussion and research. Conclusion: At present data regarding the risk of gynecological cancers after infertility treatments are reassuring. Careful evaluation of female fertility-sparing options in young women interested by ovarian, endometrial, or cervical tumors should be carried out involving a multidisciplinary team and ensuring safety and efficacy.

Oncologic and obstetric outcomes after simple conization for fertility-sparing surgery in FIGO 2018 stage IB1 cervical cancer

2021 ◽  
Vol 31 (3) ◽  
pp. 452-456
Author(s):  
Francesco Fanfani ◽  
Luigi Pedone Anchora ◽  
Giampaolo Di Martino ◽  
Nicolò Bizzarri ◽  
Maria Letizia Di Meo ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Early Stage ◽  
Fetal Loss ◽  
Disease Free Survival ◽  
Figo Stage ◽  
Oncologic Outcomes ◽  
Obstetric Outcomes ◽  
Gynecology And Obstetrics ◽  
Fertility Sparing

ObjectiveConization/simple trachelectomy is feasible in patients with early-stage cervical cancer. Retrospective data suggest that conization with negative lymph nodes could be a safe option for these patients. This study aims to provide oncologic and obstetric outcomes of a large series of patients with 2018 International Federation of Gynecology and Obstetrics (FIGO) stage IB1 cervical cancer managed by conization.MethodsPatients with early cervical cancer and a desire to preserve fertility who underwent conization and pelvic lymphadenectomy from January 1993 to December 2019 in two Italian centers were included. Inclusion criteria were: age >18 years and ≤45 years, 2018 FIGO stage IB1, no prior irradiation or chemotherapy, absence of pre-operative radiologic evidence of nodal metastases, a strong desire to preserve fertility, and absence of concomitant malignancies. We excluded patients with confirmed infertility, neuroendocrine tumor, clear cell or mucinous carcinoma.ResultsA total of 42 patients were included. The median age was 32 years (range 19–44) and median tumor size was 11 mm (range 8–20). Squamous cell carcinoma was found in 27 (64.3%). Grade 3 tumor was present in 7 (16.7%) patients and lymphovascular space involvement was detected in 15 (35.7%). At a median follow-up of 54 months (range 1–185), all patients were alive without evidence of disease. In the entire series three patients experienced recurrence resulting in an overall recurrence rate of 7.1%. All the recurrences occurred in the pelvis (2 in the cervix and 1 in the lymph nodes), resulting in a 3-year disease-free survival of 91.6%. Twenty-two (52%) patients tried to conceive; 18 pregnancies occurred in 17 patients and 12 live births were reported (6 pre-term and 6 term pregnancies). Two miscarriages were recorded, one first trimester and one second trimester fetal loss.ConclusionsOur study showed that conization is feasible for the conservative management of women with stage IB1 cervical cancer desiring fertility. Oncologic outcomes appear favorable in this series of patients. Future prospective studies will hopefully provide further insight into this important question.

scholarly journals The role of MRI in cervical cancer > 2 cm (FIGO stage IB2-IIA1) conservatively treated with neoadjuvant chemotherapy followed by conization: a pilot study

2021 ◽  
Author(s):  
Luca Russo ◽  
Benedetta Gui ◽  
Maura Miccò ◽  
Camilla Panico ◽  
Rosa De Vincenzo ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Pilot Study ◽  
Neoadjuvant Chemotherapy ◽  
Treatment Response ◽  
Young Women ◽  
Figo Stage ◽  
Tumor Diameter ◽  
Recist 1.1 ◽  
Fertility Sparing

Abstract Introduction MRI is very accurate in selecting young women with cervical cancer for fertility-sparing surgery (FSS), in particular radical hysterectomy (RH). In order to improve obstetrical outcomes, neoadjuvant chemotherapy (NACT) followed by cold knife conization (CKC) has been proposed as alternative technique. Objective To investigate the role of MRI in evaluation of response to treatment after neoadjuvant chemotherapy (NACT), followed by CKC, in patients with cervical cancer FIGO stage IB2-IIA1 with tumor size 2 – 4 cm, desiring to preserve their fertility. Methods 13 young women (23–36 years old) with cervical cancer stage IB2-IIA1 desiring to preserve their fertility were included. Tumor diameter at baseline and after treatment was detected on 1.5 T MRI. Treatment response was assessed according to Response Evaluation Criteria in Solid Tumors (RECIST 1.1) and then compared to histopathology result. Results MRI correctly assessed 11 out of 13 cases, according to RECIST 1.1, compared to histopathology. Among these 7 patients with partial response (PR), 2 cases of CR, 1 SD and 1 PD with persistence or enlargement of primary tumor. Conclusion Our pilot study supports the usefulness of MRI in assessment of treatment response after NACT, followed by CKC. Trial registration number ClinicalTrials.gov: NCT02323841

Conservative treatment in cervical cancer

2016 ◽  
Vol 4 (2) ◽  
pp. 7-11
Author(s):  
Alice Bergamini ◽  
Philippe Morice
Keyword(s):  
Cervical Cancer ◽  
Conservative Treatment ◽  
Early Stage ◽  
Figo Stage ◽  
Reproductive Age ◽  
Current Evidence ◽  
Obstetric Outcomes ◽  
Controversial Issues ◽  
Fertility Sparing ◽  
Cervical Tumors

Cervical cancer (CC) is increasingly being diagnosed in women of reproductive age, and fertility-sparing treatment has become an essential part of the therapeutic strategy for early stage CC (FIGO stage IA1-IB1). Conization is currently considered a safe and feasible treatment for stage IA1 CC without lymphovascular space invasion (LVSI). After the first report proposing vaginal radical trachelectomy (VRT) for the treatment of stage IB1 cervical tumors, several studies have evaluated vaginal, abdominal, and minimally-invasive approaches. Recent decades have been characterized by increased conservative treatment of more advanced tumors; in addition, several series assessing the oncological and obstetric outcomes of less radical surgery have been published. This review provides and overview of current evidence-based knowledge about the conservative management of CC, focusing on new perspectives and controversial issues.

Neoadjuvant chemotherapy and vaginal radical trachelectomy for fertility-sparing treatment in women affected by cervical cancer (FIGO stage IB–IIA1)

2011 ◽  
Vol 122 (3) ◽  
pp. 484-490 ◽  
Author(s):  
Pierangelo Marchiole ◽  
Jean-Dominique Tigaud ◽  
Sergio Costantini ◽  
Serafina Mammoliti ◽  
Annie Buenerd ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Figo Stage ◽  
Radical Trachelectomy ◽  
Stage Ib ◽  
Fertility Sparing

Conization and lymph node evaluation as a fertility-sparing treatment for early stage cervical cancer

2021 ◽  
Vol 31 (3) ◽  
pp. 457-461
Author(s):  
Fabio Martinelli ◽  
Antonino Ditto ◽  
Francesca Filippi ◽  
Daniele Vinti ◽  
Giorgio Bogani ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Early Stage ◽  
Figo Stage ◽  
Pelvic Lymphadenectomy ◽  
Definitive Treatment ◽  
Sentinel Node Mapping ◽  
Fertility Sparing ◽  
Early Stage Cervical Cancer ◽  
Lymph Node Evaluation

IntroductionTo evaluate oncological and obstetrical outcomes of early stage cervical cancer patients who underwent conservative management to retain childbearing potential.MethodsData of women (aged <40 years) who underwent fertility sparing treatment for International Federation of Gynecology and Obstetrics (FIGO) stage IA1 with lymphovascular invasion (LVSI) and IB1 cervical cancer were prospectively collected. All patients underwent cervical conization/s and laparoscopic nodal evaluation (pelvic lymphadenectomy/sentinel node mapping). Oncological and obstetrical outcomes were assessed.ResultsOverall, 39 patients met inclusion criteria; 36 (92.3%) women were nulliparous. There were: 3 (7.7%) IA1-LVSI+; 11 (28.2%) IA2; and 25 (64.1%) IB1 cervical cancers, according to 2018 FIGO stage classification. Histological types were 22 (56.4%) squamous carcinoma and 17 (43.6%) adenocarcinoma. Pelvic lymphadenectomy was performed in 29 (74.4%) patients, while 10 (25.6%) patients had only sentinel node mapping. In 4 (10.3%) patients conservative treatment was discontinued due to nodal involvement and 2 (5.1%) patients requested definitive treatment (hysterectomy) after a negative lymph node evaluation. Among 33 (84.6%) patients who retained their childbearing potential, 17 (51.5%) had a second conization. 2 (6.1%) patients relapsed and underwent definitive treatment. After a median follow-up of 51 months (range 1–184) no deaths were reported. 22 (70.9%) patients attempted to conceive. There were 13 natural pregnancies among 12 (54.5%) women who got pregnant. Live birth rate was 76.9%: 9 (69.2%) term and 1 (7.7%) preterm (at 32 weeks) deliveries. 2 (15.4%) miscarriages (first and second trimester) and 1 (7.7%) termination of pregnancy for medical reasons were recorded.ConclusionConization plus laparoscopic nodal evaluation may be a safe and feasible conservative option in the setting of fertility-sparing treatment for early-stage cervical cancer patients.

Preoperative evaluation of uterine isthmus-cervical infiltration in patient with cervical cancer using nuclear magnetic resonance

2013 ◽  
Vol 21 (3-4) ◽  
pp. 87-90
Author(s):  
Aljosa Mandic ◽  
Tamara Vujkov ◽  
Natasa Prvulovic ◽  
Bojana Gutic ◽  
Slavica Knezevic-Usaj
Keyword(s):  
Cervical Cancer ◽  
Magnetic Resonance ◽  
Positive Predictive Value ◽  
Fertility Preservation ◽  
Predictive Value ◽  
Histopathological Examination ◽  
Young Patients ◽  
Figo Stage ◽  
Uterine Corpus ◽  
Fertility Sparing

Background: During the last three decades, fertility preservation has been established as a new treatment modality for young patients with early cervical cancer. In preservation of the uterine corpus in fertility sparing surgery one of the most important factors is evaluation of absence of internal uterine ostium or uterine corpus tumor infiltration. The aim was to evaluate the accuracy of nucler magnetic resonance (NMR) in detection of infiltration of uterine isthmuscervical part in cervical cancer patients without fertility preservation. Methods: In 60 patients with cervical cancer FIGO stage IA-2 - IVA, NMR was performed before the operation. Radical hysterectomy Piver class III was performed in 57 patients and pelvic exenteration in three patients with FIGO stage IVA. The histopathological material was examed at the Department of pathology and cytology and it was used as a gold standard. Results: The patient average age was 44.7, (range: 25-65 years). Squamous cervical cancer was diagnosed in 53 (88.3%), adenocarcinoma in 4 (6.7%), and adenosquamous carcinoma in 3 (5%) patients. According to NMR findings, 7 (11.7%) patients were with uterine isthmus-cervical infiltration when compared with histopathological examination, which established infiltration in 10 (16.7%) patients. Sensitivity of NMR was 60%, specificity 98%, positive predictive value 85.7%, and negative predictive value was 92.5% with overall accuracy 91.7%. Conclusion: Sensitivity of NMR was low compared with other studies but with high specificity and overall accuracy. The positive predictive value was relatively acceptable. Negative findings of NMR for corporal infiltration and precise evaluation of the depth of stromal infiltration and length of the proximal cervix without infiltration are important in preoperative diagnostic for fertility preservation surgery.

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