Radical Vaginal Trachelectomy After Laparoscopic Staging and Neoadjuvant Chemotherapy in Women With Early-Stage Cervical Cancer Over 2 cm: Oncologic, Fertility, and Neonatal Outcome in a Series of 20 Patients

Abstract

Laparoscopic lymphadenectomy followed by NACT and RVT in pN0 patients with cervical cancer of more than 2 cm seems to be an oncologically safe procedure with promising fertility outcomes.

Incidence, risk factors and treatment of cervical stenosis after radical trachelectomy: A systematic review

“…The impact of neoadjuvant chemotherapy on stenosis is unclear. Based on the limited articles published in the literature, the incidence of cervical stenosis after neoadjuvant chemotherapy and VRT, which varied from 16.7% to 25%, was higher than that without neoadjuvant chemotherapy [29][30][31]. Robova et al hold the opinion that this might due to change of the tissues after chemotherapy.…”

Oncological and pregnancy outcomes after high-dose density neoadjuvant chemotherapy and fertility-sparing surgery in cervical cancer

“…A variety of chemotherapeutic protocols have been used followed by fertility-sparing surgery. The first-line combination of TIP (paclitaxel, Ifosfamide and cisplatin) or TEP (paclitaxel, epirubicin and cisplatin) is currently most often used [7,11,12,14,15]. There are more complete responses, but the interval between chemotherapy normally varies between 21 and 28 days.…”

“…Lymphadenectomy before NAC is probably a safer procedure, mainly because fertility-sparing surgery is offered only to "true" lymph node negative patients [12]. NAC reduced the number of lymph node positive patients [5,13].…”

Neoadjuvant chemotherapy followed by conization to spare fertility in cases of locally advanced cervical cancer: A case report and review of the literature

“…Furthermore, NACT also allows for a possible decrease in the extent of surgery to preserve some cervical tissue to achieve an improved pregnancy outcome. Marchiole et al (15), Tsuji et al (16) and Lanowska et al (17) reported that 28 patients whose tumours were >2 cm or who had chemosensitive bulky disease received NACT, followed by fertility-sparing surgery, which consisted of RT and lymphadenectomy. Of these cases, one developed recurrent disease.…”