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 ◽  
...  
Author(s):  
Aljosa Mandic ◽  
Miona Davidovic-Grigoraki ◽  
Bojana Gutic ◽  
Natasa Prvulovic Bunovic ◽  
Nenad Solajic ◽  
...  

2018 ◽  
Vol 12 (1) ◽  
pp. 37
Author(s):  
IN Gede Budiana ◽  
Tjokorda Gede Astawa Pemayun

Cervical cancer is a malignancy in women that cause major impacts, not only biologically, but also in various aspects of life. On patients during reproductive age, cervical cancer poses severe sexual and reproductive debilitation. Trend in the onset of first diagnosis is moving towards younger age, and mostly affect women in their reproductive age. This would give a bad impact on the sustainability of the patient’s reproductive function. Until now, fertilitysparing approach for the management of early-stage cervical cancer is still rare in Indonesia. However, some options of conservative surgical therapy are available for patients who desire fertility, namely conization, simple tracellectomy, radical trachelectomy, and also neoadjuvant chemotherapy. These options have been proven effective and safe, while maintaining patients’ reproductive functions. ABSTRAKKanker serviks merupakan suatu penyakit keganasan pada wanita yang memiliki dampak luas, tidak hanya pada tubuh penderita, namun juga berbagai aspek kehidupan penderita. Pada penderita di usia reproduktif, kanker serviks menimbulkan masalah seksual dan reproduksi yang berat bagi penderita. Kini usia dimana terjadinya kanker serviks mulai menunjukkan kecenderungan yang semakin muda yang tentunya memberikan dampak buruk terhadap keberlangsungan fungsi reproduksi pasien. Hingga saat ini, tatalaksana kanker serviks stadium awal dengan pendekatan fertility-sparing masih jarang dilakukan di Indonesia. Namun, beberapa pilihan terapi bedah konservatif tersedia bagi pasien yang menginginkan fertilitas, yakni konisasi, trakelektomi sederhana, trakelektomi radikal. hingga pemberian kemoterapi neo-adjuvant. Pilihan terapi ini telah terbukti efektif dan aman, serta mampu mem pertahankan fungsi reproduksi pasien.


2019 ◽  
Vol 30 (1) ◽  
pp. 115-121 ◽  
Author(s):  
Freweini Martha Tesfai ◽  
Judith R Kroep ◽  
Katja Gaarenstroom ◽  
Cor De Kroon ◽  
Rhiannon Van Loenhout ◽  
...  

ObjectiveTo assess the feasibility, safety, oncological, and obstetric outcomes in patients with cervical tumors >2 cm treated with neoadjuvant chemotherapy in preparation for abdominal radical trachelectomy.MethodsA retrospective analysis of patients with cervical cancer >2 cm (up to 6 cm) was conducted in patients who were selected to receive neoadjuvant chemotherapy before abdominal radical trachelectomy. Surgical and clinical outcomes were examined in relation to radiological and pathological results. In addition, obstetric outcomes were described. The Mann–Whitney U test and Fisher’s exact test were performed to compare radiological findings between successful and unsuccessful abdominal radical trachelectomy procedures. International Federation of Gynecology and Obstetrics (FIGO) 2009 staging classification was used for this study.ResultsA total of 19 women were treated with neoadjuvant chemotherapy for cervical tumors >2 cm at our institution between May 2006 and July 2018. The median age was 28 years (range 19–36). The distribution of FIGO stages was seven patients stage IB1 (37%), 10 patients stage IB2 (53%), and two patients (10%) stage IIA. Mean clinical tumor size was 4.4 cm (range 3.5–6.0). Histology revealed 74% cases of squamous cell carcinoma. The remaining patients had adenocarcinoma (21%) and only one patient had clear cell adenocarcinoma (5%). Chemotherapy consisted of six weekly cycles of cisplatin (70 mg/m2) and paclitaxel (70 mg/m2). In 15 of the 19 patients (74%) fertility was successfully preserved. In the four patients in whom fertility preservation failed, one patient had stable disease after three cycles and did not meet the criteria for fertility-sparing surgery and three patients had intra- or post-operative indications for adjuvant therapy. Three of the 19 patients (15.7%) had a relapse, two of whom died. One case was in the group of successful abdominal radical trachelectomy.ConclusionNeoadjuvant chemotherapy followed by fertility-sparing surgery may be a feasible and safe option in select patients with cervical tumors >2 cm. Unfavorable prognostic factors are defined as non-responsiveness and non-squamous pathology, which can help in patient selection for fertility-sparing surgery.


Author(s):  
Luca Russo ◽  
Benedetta Gui ◽  
Maura Miccò ◽  
Camilla Panico ◽  
Rosa De Vincenzo ◽  
...  

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


2015 ◽  
Vol 139 (3) ◽  
pp. 447-451 ◽  
Author(s):  
Rawand Salihi ◽  
Karin Leunen ◽  
Erik Van Limbergen ◽  
Philippe Moerman ◽  
Patrick Neven ◽  
...  

2021 ◽  
Author(s):  
Tao Chen ◽  
Jia Li ◽  
Yan Zhu ◽  
AnWei Lu ◽  
Li Zhou ◽  
...  

Abstract Purpose To explore the oncological and obstetric results after radical trachelectomy in early-stage cervical cancer. Methods Retrospective analysis of the oncological and obstetric results to 23 patients with early cervical cancer (stage IA2-IB3; International Federation of Gynecology and Obstetrics 2018) accepting radical trachelectomy in The Maternal and Child Health Care Hospital of Guiyang from Oct 2004 to Sep 2018. Results Among those patients with tumor size>4cm (up to 5cm) three patients who wished to preserve fertility accepted radical trachelectomy after neoadjuvant chemotherapy. 23 patients had cervical tumors of the histological type squamous cell carcinoma (SCC). All of the patients retained reproductive function. The mean time of the follow-up was 112.87±55.75months(36-199months). The median tumor size was 2.00±1.35cm (invisible by eyes-5.00cm). No occurred recurrence in any of the cases. Pregnancy outcomes are described as follows: 17 cases attempted to pregnancy, in which 8 cases (47.06%) conceived 12 times. First-trimester abortion and voluntary abandonment of pregnancy occurred in 4 cases (33.33%) respectively, one among patients who choose to abandon pregnancy being induced at 24 weeks of gestation. Second-trimester abortion occurred in3 cases (25.0%), and the reason for abortion was chorioamnionitis. Premature delivery at 32 weeks occurred once (8.33%). Conclusion Radical trachelectomy is a safe and effective treatment for young women with early-stage cervical cancer. Neoadjuvant chemotherapy and Radical trachelectomy provides the possibility of preserving pregnant ability for patients with cervical tumor>4cm. However, it is worth further exploration.


2016 ◽  
Vol 23 (S5) ◽  
pp. 841-849 ◽  
Author(s):  
Violante Di Donato ◽  
Michele Carlo Schiavi ◽  
Ilary Ruscito ◽  
Virginia Sibilla Visentin ◽  
Innocenza Palaia ◽  
...  

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