Oncologic results of fertility sparing surgery of cervical cancer: An updated systematic review

被引：41

作者：

Morice, P. ^{[1
,2
,3
]}

Maulard, A. ^{[1
]}

Scherier, S. ^{[1
]}

Sanson, C. ^{[1
]}

Zarokian, J. ^{[1
]}

Zaccarini, F. ^{[1
]}

Espenel, S. ^{[4
]}

Pautier, P. ^{[5
]}

Leary, A. ^{[5
,6
]}

Genestie, C. ^{[7
]}

Chargari, C. ^{[2
,4
]}

Grynberg, M. ^{[3
,8
]}

Gouy, S. ^{[1
]}

机构：

[1] Gustave Roussy, Dept Gynecol Surg, Canc Campus,114 Rue Edouard Vaillant, F-94805 Villejuif, France

[2] Gustave Roussy, INSERM, Unit 10 30, Villejuif, France

[3] Univ Paris Sud Paris XI, Le Kremlin Bicetre, France

[4] Gustave Roussy, Dept Radiat Oncol, Villejuif, France

[5] Gustave Roussy, Dept Med Oncol, Villejuif, France

[6] Gustave Roussy, INSERM, Unit 981, Villejuif, France

[7] Gustave Roussy, Dept Pathol, Villejuif, France

[8] Hop Antoine Beclere, Dept Reprod Med, Clamart, France

来源：

GYNECOLOGIC ONCOLOGY | 2022年 / 165卷 / 01期

关键词：

Early-stage cervical cancer; Conservative treatment; Conisation; Trachelectomy; Neoadjuvant chemotherapy; Fertility; Prognostic factor; Radical trachelectomy; Recurrence; LAPAROSCOPIC RADICAL TRACHELECTOMY; SIMPLE VAGINAL TRACHELECTOMY; LONG-TERM OUTCOMES; NEOADJUVANT CHEMOTHERAPY; PELVIC LYMPHADENECTOMY; OBSTETRIC OUTCOMES; SIMPLE CONIZATION; YOUNG-PATIENTS; PERIOPERATIVE OUTCOMES; CONSERVATIVE TREATMENT;

D O I：

10.1016/j.ygyno.2022.01.023

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background. Several techniques can be proposed as fertility sparing surgery in young patients treated for cervical cancer but uncertaincies remain concerning their outcomes. Analysis of oncological issues is then the first aim of this review in order to evaluate the best strategy. Results. Data were identified from searches of MEDLINE, Current Contents, PubMed and from references in relevant articles from January 1987 to 15th of September 2021. We carry out an updated systematic review involving 5862 patients initially selected for fertility-sparing surgery in 275 series. Findings. In patients having a stage IB1 disease, recurrence rate/RR in patients undergoing simple conisation/ trachelectomy, radical trachelectomy/RT by laparoscopico-vaginal approach, laparotomic or laparoscopic approaches are respectively: 4.1%, 4.7%, 2.4% and 5.2%. In patients having a stage IB2 disease, RR after neoadjuvant chemotherapy or RT by laparotomy are respectively 13.2% and 4.8% (p = .0035). After neoadjuvant treatment a simple cone/trachelectomy was carried out in 91 (30%) patients and a radical one in 210 (70%) cases. But the lowest pregnancy rate is observed in patients undergoing RT by laparotomy (36%). Conclusions. The choice between these treatments should be based above all, on objective oncological data that strike a balance for each procedure between the best chances for cure and the fertility results. In patients having a stage IB1 disease, oncological results are quite similar according to the procedure used. In patients having a stage IB2 disease, RT by open approach has the lowest RR. Anyway the lowest pregnancy rate is observed in patients undergoing RT by laparotomy. (C) 2022 Elsevier Inc. All rights reserved.

引用

页码：169 / 183

页数：15

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