Long-term results of fertility-sparing treatment for early-stage cervical cancer

被引:35
作者
Bogani, Giorgio [1 ]
Chiappa, Valentina [1 ]
Vinti, Daniele [1 ,2 ,3 ]
Somigliana, Edgardo [1 ,2 ,3 ]
Filippi, Francesca [1 ,2 ]
Murru, Giulia [1 ]
Murgia, Ferdinando [1 ]
Martinelli, Fabio [1 ]
Ditto, Antonino [1 ]
Raspagliesi, Francesco [1 ]
机构
[1] Fdn IRCCS Ist Nazl Tumori Milano, Via Venezian 1, I-20133 Milan, Italy
[2] Univ Milan, Dept Clin Sci & Community Hlth, Milan, Italy
[3] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Dept Obstet Gynecol, Milan, Italy
关键词
Cervical cancer; Fertility-sparing; Conservative surgery; Lymph node; Conization; RADICAL-TRACHELECTOMY; VAGINAL TRACHELECTOMY; SURGERY; LYMPHADENECTOMY; CONIZATION; OPTIONS;
D O I
10.1016/j.ygyno.2019.04.007
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective. To evaluate the long-term outcomes of young early stage cervical cancer patients wishing to preserve their childbearing potential. Methods. Data of young (aged <40 years) patients with early stage cervical cancer were prospectively collected. All patients with stage IA2,IB1 and IB2 cervical cancer were included; they have cervical conization and pelvic node dissection performed via minimally invasive surgery. Survival outcomes were assessed with the Kaplan-Meier model. Results. Overall, 32 patients met the inclusion criteria. Mean (SD) age of the population included was 33 (+/- 4). According to the FIGO 2018 staging system, the stage of disease was IA2, IB1 and 182 in 9 (28%), 21 (66%) and 2 (6%) cases, respectively. All patients included had cervical conization and laparoscopic pelvic node assessment, including systematic pelvic lymphadenectomy (N = 30, 94%) and sentinel node mapping (N = 2, 6%). In six (19%) patients the planned conservative treatment was discontinued. Median follow-up was 75 (range, 12-184) months. No recurrent disease was diagnosed among patients undergoing conservative treatment; while 2 out of 6 patients having definitive surgical or radiotherapy treatments developed recurrent disease. Five-year disease free and overall survivals were 94% and 97%, respectively. Considering reproductive outcomes, 11 (69%) out of 16 patients who attempted to conceive got pregnant Conclusions. Cervical conization and pelvic nodes assessment could be considered a valid treatment modality for early-stage cervical cancer patients who are wishing to preserve their childbearing potential. (C) 2019 Published by Elsevier Inc.
引用
收藏
页码:89 / 94
页数:6
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