TY - JOUR
T1 - Neo-adjuvant chemotherapy in fertility-sparing cervical cancer treatment
AU - Kasius, Jenneke C
AU - van der Velden, Jacobus
AU - Denswil, Nerissa P
AU - Tromp, Jacqueline M
AU - Mom, Constantijne H
N1 - Publisher Copyright:
© 2021
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/2/20
Y1 - 2021/2/20
N2 - 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.
AB - 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.
KW - Cervical cancer
KW - Fertility sparing treatment
KW - Neo-adjuvant chemotherapy
KW - Trachelectomy
UR - http://www.scopus.com/inward/record.url?scp=85103021597&partnerID=8YFLogxK
U2 - 10.1016/j.bpobgyn.2021.01.010
DO - 10.1016/j.bpobgyn.2021.01.010
M3 - Review article
C2 - 33752979
JO - Baillière's Best Practice and Research. Clinical Obstetrics and Gynaecology
JF - Baillière's Best Practice and Research. Clinical Obstetrics and Gynaecology
SN - 1521-6934
ER -