%0 Journal Article
%T Fertility-Preserving Surgery in Patients with Early Stage Cervical Carcinoma
%A Spyridon Kardakis
%J ISRN Oncology
%D 2012
%R 10.5402/2012/817065
%X 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 ˇ°golden standardˇ± for the management of early cervical cancer in young women. 1. Introduction Cervical cancer is the seventh most common malignancy in developed countries, and the second most common cancer in developing countries [1]. In 2004, 30,570 new cases of invasive cervical cancer were diagnosed in the European Union [1]. In 2012, the estimated new cases in the USA are 12,170, and the estimated deaths 4,220 [2]. Higher incidence occurs in countries where an effective screening program is not present [1]. In the USA, the incidence of cervical cancer is about 6.8 per 100,000 person and the mortality 2.4/100,000. Gynecological malignancies often affect women in reproductive age and about 28% of all cervical cancers is diagnosed prior to 40 years of age [3]. Where a screening program is present, the disease is often diagnosed in early stages with high survival rates. In the USA, between 2001 and 2007 the 5-year survival for localized disease in white women under 50 years old was 94.2% [4]. The golden standard treatment of early stage disease ranges from simple hysterectomy (stage IA1) to a radical hysterectomy (RH) and pelvic lymphadenectomy (IA2 to IB1). Nevertheless, the high survival rates and the delayed childbearing in our society result in more cervical cancer patients who desire preserving their fertility. Luckily, fertility sparing treatment approaches are available for a large part of cases. Cervical conization is a feasible
%U http://www.hindawi.com/journals/isrn.oncology/2012/817065/