Table of Contents
ISRN Oncology
Volume 2012 (2012), Article ID 817065, 12 pages
http://dx.doi.org/10.5402/2012/817065
Review Article

Fertility-Preserving Surgery in Patients with Early Stage Cervical Carcinoma

Department of Obstetrics and Gynaecology, Oncologic Clinic, Västerås Hospital, 72212 Västerås, Sweden

Received 12 October 2012; Accepted 30 October 2012

Academic Editors: G. Gatti, G. Kovacs, and L.-M. Sun

Copyright © 2012 Spyridon Kardakis. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Fertility preservation is an important issue for patients in reproductive age with early stage cervical cancer. In view of recent developments, our purpose was to review and discuss available surgical alternatives. A literature search was conducted using PUBMED, including papers between 1980 and December 2011. In patients with stage IA1 cervical cancer, conization is a valid alternative. Patients with stage IA2-IB1 disease can be conservatively treated by radical trachelectomy. This is as well-established conservative approach and appears to be safe and effective in allowing a high chance of conception. Prematurity is the most serious issue in pregnancies following trachelectomy. Less invasive options such as simple trachelectomy or conization seem to be feasible for stages IA2-IB1, but more and better evidence is needed. Neoadjuvant therapy might allow conservative surgery to be performed also in patients with more extensive lesions. Ovarian transposition is important when adjuvant radiation is needed. In conclusion, available literature shows that there are interesting fertility-sparing treatment alternatives to the “golden standard” for the management of early cervical cancer in young women.