2019
DOI: 10.1136/ijgc-2019-000647
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Fertility-sparing surgery of cervical cancer >2 cm (International Federation of Gynecology and Obstetrics 2009 stage IB1–IIA) after neoadjuvant chemotherapy

Abstract: ObjectiveTo assess the feasibility, safety, oncological, and obstetric outcomes in patients with cervical tumors >2 cm treated with neoadjuvant chemotherapy in preparation for abdominal radical trachelectomy.MethodsA retrospective analysis of patients with cervical cancer >2 cm (up to 6 cm) was conducted in patients who were selected to receive neoadjuvant chemotherapy before abdominal radical trachelectomy. Surgical and clinical outcomes were examined in relation to radiological and pathological results… Show more

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Cited by 32 publications
(54 citation statements)
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“…The surgical interventions included vaginal radical trachelectomy (VRT, N = 19) [2,7,9,18,21,26,32,35,36,38,42,43,[45][46][47][48]51,54,55], abdominal radical trachelectomy (ART, N = 15) [2,6,10,14,16,19,[22][23][24]27,28,30,39,52,53], minimally invasive radical trachelectomy (MIS-RT, N = 9) (laparoscopic radical trachelectomy [LRT], N = 7; robotic radical trachelectomy, N = 2) [12,17,20,26,27,29,32,37,45] and simple vaginal trachelectomy [SVT] or conization, (N = 15) (SVT, N = 6; cone, N = 6; both, N = 3) [8,11,13,15,25,33,34,40,41,44,47,49,50,56−58]. Neoadjuvant chemotherapy (NACT) was used primarily in 6 studies, followed by SVT or cone (N = 2), VRT (N = 1), or ART (N = 1) [23,31,38...…”
Section: Primary Study Characteristicsmentioning
confidence: 99%
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“…The surgical interventions included vaginal radical trachelectomy (VRT, N = 19) [2,7,9,18,21,26,32,35,36,38,42,43,[45][46][47][48]51,54,55], abdominal radical trachelectomy (ART, N = 15) [2,6,10,14,16,19,[22][23][24]27,28,30,39,52,53], minimally invasive radical trachelectomy (MIS-RT, N = 9) (laparoscopic radical trachelectomy [LRT], N = 7; robotic radical trachelectomy, N = 2) [12,17,20,26,27,29,32,37,45] and simple vaginal trachelectomy [SVT] or conization, (N = 15) (SVT, N = 6; cone, N = 6; both, N = 3) [8,11,13,15,25,33,34,40,41,44,47,49,50,56−58]. Neoadjuvant chemotherapy (NACT) was used primarily in 6 studies, followed by SVT or cone (N = 2), VRT (N = 1), or ART (N = 1) [23,31,38...…”
Section: Primary Study Characteristicsmentioning
confidence: 99%
“…To address the recurrence rate of larger tumors and increase the success of fertility preservation in those strongly desiring pregnancy, NACT before FSS has been reported (Table 5). Chemotherapy regimens described in the literature include paclitaxel/ifosfamide/cisplatin, paclitaxel/etoposide/cisplatin, ifosfamide/cisplatin, doxorubicin/ cisplatin and paclitaxel/cisplatin at varying doses and frequencies [23,32,38,40,50,54].…”
Section: Role Of Nactmentioning
confidence: 99%
“…This trial simply examined the efficacy of NACT combined with radical surgery in treating locally advanced cervical squamous cell carcinoma. In theory, NACT can shrink tumors, improve parauterine infiltration, 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 15 ]. Significant differences were found in the number of intraoperative dissected lymph nodes, deep muscle infiltration, and vascular tumor thrombus in the experimental group after NACT compared with the control group.…”
Section: Discussionmentioning
confidence: 99%
“…It can improve the surgical resection rate of patients; decrease the incidence of parathymic infiltration, vascular thrombin level, and local and distant lymph node metastasis; and greatly reduce the incidence of postoperative pathological high-risk factors. 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%
“…However, the role of NACT in cervical cancer is controversial. On the one hand, NACT has been reported to help to implement fertility-sparing surgery for selected patients [11], or improve the resection and survival rate [12]. On the other hand, some literature deemed that the addition of NACT is not superior and is possibly inferior than the CCRT or surgery alone [8,13].…”
Section: Introductionmentioning
confidence: 99%