Fertility-Sparing Surgery for Early-Stage Cervical Cancer: A Systematic Review of the Literature

نویسندگان

چکیده

ObjectiveThis systematic review aimed to evaluate oncologic and reproductive outcomes after fertility-sparing surgery (FSS) for early-stage cervical cancer (early CC).Data SourcesOvid MEDLINE, Ovid EMBASE, Cochrane CENTRAL were searched from 1980 the present using Medical Subject Headings terms; other controlled vocabulary keywords related fertility, cancer, surgical techniques.Methods of Study SelectionA total 2415 studies screened, with 53 included. Studies reporting recurrences a median follow-up 12 months in early CC (International Federation Gynecology Obstetrics 2009 stages IA lymphovascular space invasion, IB, or IIA) traditional histologic type undergoing FSS included.Tabulation, Integration, ResultsThe grouped by intervention, including vaginal radical trachelectomy (VRT), abdominal (ART), minimally invasive (MIS-RT), conization simple (ST), involving neoadjuvant chemotherapy (NACT). Combined rates recurrence (RR), death (CDR), pregnancy (PR), live birth (LBR) calculated per procedure on basis all included that reported procedure.The results as follows:VRT: RR 4%, CDR 1.7%, PR 49.4%, LBR 65.0%ART: 3.9%, 1.4%, 43.2%, 44.0%MIS-RT: 4.2%, 0.7%, 36.2%, 57.1%Cone ST: 0.8%, 55.1%, 71.9%NACT: 7.5% 2.0%ConclusionFSS VRT, ART, MIS-RT have comparable carefully selected patients, favoring VRT. Data nonradical cone ST are less robust but support similar fewer complications. NACT this setting requires more investigation before routine implementation into practice.

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Fertility-Sparing Surgery for Early-Stage Cervical Cancer

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ژورنال

عنوان ژورنال: Journal of Minimally Invasive Gynecology

سال: 2021

ISSN: ['1553-4650', '1553-4669']

DOI: https://doi.org/10.1016/j.jmig.2020.10.013