Neo-adjuvant chemotherapy in fertility-sparing cervical cancer treatment

Jenneke C Kasius, Jacobus van der Velden, Nerissa P Denswil, Jacqueline M Tromp, Constantijne H Mom

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

The current review provides a literature overview of studies assessing the oncological and fertility outcomes of treatment with neo-adjuvant chemotherapy followed by fertility-sparing surgery in patients with cervical cancer >2 cm. Six cohort studies were included showing severe heterogeneity regarding patient selection, chemotherapy regimen, and surgical approach. In total, 111 patients were studied, with overall favorable characteristics. Patients were on average 29 years old, had a tumor of 36 mm, no lymph node metastasis, and response to chemotherapy. In approximately 5-year follow-up, the recurrence rate was 13% (0%-21%) and overall death rate 2.7% (0%-10%). Three patients were alive with recurrent disease (2.7% and 0%-11%). Of the 111 patients, 90 underwent successful fertility-sparing treatment (83%). Roughly one-third conceived and one-fourth had a healthy live-born child. More research is essential to determine proper selection criteria for fertility-sparing treatment of cervical cancer >2 cm and the optimal treatment management.

Original languageEnglish
JournalBaillière's Best Practice and Research. Clinical Obstetrics and Gynaecology
Early online date20 Feb 2021
DOIs
Publication statusE-pub ahead of print - 20 Feb 2021

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