EP412 Fertility sparing surgery of &gt;2 cm cervical cancer following neo-adjuvant chemotherapy: a 12-year experience in a single tertiary care center

Tesfai, F; Kroep, Judith R.; Nout, Remi A.; Gaarenstroom, K.N.; Kroon, Cornelis D. de; Loenhout, Rhiannon Van; Smit, Vincent T.H.B.M.; Trimbos, J. Baptist; Poelgeest, M. van; Beltman, Jogchum Jan

doi:10.1136/ijgc-2019-esgo.471

Cited by 2 publications

(5 citation statements)

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“…This trial simply examined the e cacy of NACT combined with radical surgery in treating locally advanced cervical squamous cell carcinoma. In theory, NACT can shrink tumors, improve parauterine in ltration, create conditions for surgery, and increase surgical resection rate; decrease tumor cell activity; and reduce the potential risk of intraoperative spread and postoperative recurrence and metastasis [7,[11][12][13][14][15] . Signi cant differences were found in the number of intraoperative dissected lymph nodes, deep muscle in ltration, and vascular tumor thrombus in the experimental group after NACT compared with the control group.…”

Section: Discussionmentioning

confidence: 99%

“…It can also enable many young patients with early cervical squamous cell carcinoma to retain fertility, but its role in improving prognosis is still controversial [5][6][7] . Several meta-analyses evaluated the prognosis of neoadjuvant chemotherapy combined with surgical treatment and initial surgical treatment, and the results were different [8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

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Neoadjuvant chemotherapy combined with radical surgery for stage IB2/IIA2 cervical squamous cell carcinoma:A prospective, randomized controlled study of 35 patients

Huang

Zhenrong

et al. 2021

Preprint

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Objective: This study aimed to evaluate the clinical outcomes for patients with stage IB2/IIA2 cervical squamous cell carcinoma treated with neoadjuvant chemotherapy combined with radical surgery. Methods: A total of 68 patients with cervical squamous cell carcinoma were randomly divided into the experimental group (n = 35) and the control group (n = 33). The patients in the experimental group received paclitaxel plus cisplatin neoadjuvant chemotherapy for two cycles after the diagnosis of cervical squamous cell carcinoma and were rested for 2 weeks after chemotherapy, The control group underwent radical hysterectomy and bilateral adnexectomy combined with total pelvic lymph node dissection after the diagnosis of cervical squamous cell carcinoma. The toxic and side effects of chemotherapy in the experimental group were observed. Also, the operation method, operation time, blood loss, grade of wound healing, complications, and postoperative pathology were noted in the two groups. Primary foci and pelvic lymph node recurrence and distant metastasis were observed, and 3-year and 5-year survival rates were calculated. Results. Only one patient in the experiment had grade Ⅲ bone marrow suppression; no other grade III and IV chemotherapy toxic reactions were observed. The operation was successfully completed in all patients. The operation time, intraoperative blood loss, placement of ureteral catheter, bladder injury, ureteric injury, postoperative urinary tub, pelvic drainage tube indwelling time, anal exhaust time, postoperative complications, and metastatic ratio of lymph nodes were not significantly different between the two groups (P>0.05); The number of dissected lymph nodes, deep myometrial invasion, and vascular tumor emboli showed a significant difference in the experimental group compared with the control group (P < 0.05). The 3-year disease-free survival (82.9% vs 81.9%), 5-year disease-free survival (71.4% vs 60.6%), 3-year overall survival (91.4% vs 87.8%), and 5-year overall survival (82.9% vs 75.6%) were not statistically significantly different between the experimental group and the control group (P > 0.05). Conclusions. Neoadjuvant chemotherapy in ⅠB2/ⅡA2 stage cervical squamous cell carcinoma showed low toxic side effects. Radical surgery after chemotherapy is safe and feasible. It plays a coordinating role in reducing the tumor infiltration depth of the deep muscle layer and the incidence of vascular tumor emboli, reducing the use of postoperative adjuvant therapy, and improving the quality of life of patients, but does not improve the 3-year/5-year survival rate.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Neoadjuvant chemotherapy combined with radical surgery for stage IB2/IIA2 cervical squamous cell carcinoma:A prospective, randomized controlled study of 35 patients

Huang

Zhenrong

et al. 2021

Preprint

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“…Although the type of chemotherapy varies, Table 2 indicates that NACT is generally effective in reducing tumour size. In 21-68% of the patients, a complete pathological response following NACT was observed [30][31][32][34][35][36][37][38][39]. Regarding the oncological outcomes, the recurrence rate in the prospective cohort studies was 8% [38] and 14% [35].…”

Section: Neoadjuvant Chemotherapy In Figo 2018 Stage 1b2 Cervical Cancermentioning

confidence: 96%

“…Similarly, three recently published systematic reviews reported recurrence rates of 6, 9 and 13% [41–43]. RFS after fertility-sparing treatment was determined by Tesfai et al [37], who reported a 5-year RFS in the fertility-spared group of 82%, and De Vincenzo et al [38], who reported a 3-year RFS of all included patients of 77%.…”

Section: Neoadjuvant Chemotherapy In Figo 2018 Stage 1b2 Cervical Cancermentioning

confidence: 98%

“…The underlying hypothesis is that NACT reduces tumour size, which will allow for less-extensive fertility-sparing surgery (FSS), and consequently better fertility and obstetrical outcomes. Table 2 summarizes studies, which have investigated the use of NACT in 10 or more patients with FIGO 2018 stage IB2 cervical cancer [30][31][32][33][34][35][36][37][38][39][40].…”

Section: Neoadjuvant Chemotherapy In Figo 2018 Stage 1b2 Cervical Cancermentioning

confidence: 99%

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Is less more in the surgical treatment of early-stage cervical cancer?

Schaafsma

Plante

Mom

et al. 2022

Current Opinion in Oncology

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Purpose of reviewThis article discusses recent developments towards less radical surgical treatment for early-stage cervical cancer. Recent findingsSurgery is the standard treatment for early-stage cervical cancer. In the last decades, new treatment strategies have been developed aiming to reduce morbidity, without hampering oncological safety. We provide an update of the latest knowledge on safety and morbidity following less radical surgical procedures in early-stage cervical cancer. In cervical cancer with a tumour size of 2 cm or less, radical surgery (simple hysterectomy or fertility-sparing conisation) may be a well tolerated option. For patients with larger lesions (>2 cm) and wishing to preserve fertility, administration of neoadjuvant chemotherapy followed by less extensive surgery appears to be a feasible and well tolerated alternative to abdominal trachelectomy. With regard to lymph node assessment, increasing evidence shows the feasibility of the sentinel lymph node procedure instead of full pelvic lymphadenectomy. Prospective trials reporting on oncological safety are awaited. It is important to exercise caution when new surgical strategies are introduced. Despite promising retrospective data, prospective randomized studies may present unexpected results, for instance, minimally invasive radical hysterectomy showed inferior results compared to laparotomy. SummaryThere is a shift towards less radical treatment for early-stage cervical cancer. This review explores whether and when less is really more.

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EP412 Fertility sparing surgery of >2 cm cervical cancer following neo-adjuvant chemotherapy: a 12-year experience in a single tertiary care center

Cited by 2 publications

References 0 publications

Neoadjuvant chemotherapy combined with radical surgery for stage IB2/IIA2 cervical squamous cell carcinoma:A prospective, randomized controlled study of 35 patients

Neoadjuvant chemotherapy combined with radical surgery for stage IB2/IIA2 cervical squamous cell carcinoma:A prospective, randomized controlled study of 35 patients

Is less more in the surgical treatment of early-stage cervical cancer?

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