Conservative treatment in cervical cancer

Abstract

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.