Excisional cone as fertility-sparing treatment in early-stage cervical cancer.
OBJECTIVE
To describe a case series of early-stage cervical cancer patients treated with excisional cone instead of radical trachelectomy as fertility-sparing surgery.


METHODS
Prospective study.


METHODS
University hospital.


METHODS
Early-stage cervical cancer (International Federation of Gynecology and Obstetrics stage IA2-IB1), age ≤ 45 years, tumor ≤ 20 mm.


METHODS
Cold-knife conization and laparoscopic pelvic lymphadenectomy.


METHODS
Recurrence and pregnancy rate.


RESULTS
There were 17 patients: 4 (23.5%) IA2, 13 (76.5%) IB1; 12 (70.5%) squamous cell carcinoma, 4 (23.5%) adenocarcinoma, and 1 (6%) glassy cell tumor. Four cases (23.5%) involved lymphovascular space invasion. The median number of lymph nodes removed was 18 (range 13-51). None of the patients received neoadjuvant chemotherapy, and two patients (12%) received three courses of adjuvant chemotherapy. No recurrences were observed after a median follow-up of 16 months (range 8-101 months). Two of five patients (40%) attempting to conceive had a spontaneous pregnancy and delivery.


CONCLUSIONS
In selected and informed patients, conization and laparoscopic pelvic lymphadenectomy seems to be feasible as a fertility-sparing surgical approach.
Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy. anna.fagotti@rm.unicatt.it
Anna
A
Fagotti
Maria Lucia
ML
Gagliardi
Cristina
C
Moruzzi
Vito
V
Carone
Giovanni
G
Scambia
Francesco
F
Fanfani
D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D002584:Cervix Uteri / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D019092:Conization / Q000379:methods*; D042241:Early Diagnosis; D005260:Female; D005298:Fertility; D005498:Follicular Phase; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011247:Pregnancy; D018873:Pregnancy Rate; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*