title: Conservative treatment in early cervical cancer.
abstract: OBJECTIVE
  The aim of this study was to describe fertility preservation methods to improve quality of life of early stages of cervical cancer.
  
  
  RESULTS
  Although definite treatment of early stages of cervical cancer including stages IA,IB1 and IIA non-bulky is radial hysterectomy, this method is used in perimenopousal period in which fertility preservation is not important. Whenever fertility preservation is so important, some methods like radical trachelectomy and laparoscopic lymphadenectomy are used to rule out lymphatic metastases.
  
  
  CONCLUSIONS
  If any visible lesion on cervix is found, pelvic MRI is helpful and during operation, trachelectomy samples are sent for frozen section and margin study. Radical trachelectomy is done vaginal or abdominal. Overall relapse rate of cervical cancer in radical trachelectomy and radical hysterectomy is the same. Complications of radical trachelectomy include chronic vaginal discharge, abnormal uterine bleeding, dysmenorrhea, inflammation and ulcer due to cercelage, amenorrhea, cervical stenosis and pregnancy complications following trachelectomy including 2(nd) trimester abortion and premature labor following cervical prematurity.The best and preferred method of labor is cesarean section. Neoadjuant chemotherapy followed by radical trachelectomy in large cervical lesions is a suitable treatment. Ultraconservative operations like large cold knife conization, simple trachelectomy with laparoscopic lymphadenectomy and sentinel lymph node mapping are suitable for very small lesions.
authors.affiliation: Associate Prof, Gynecologist Oncologist, Shahid Sadoughi University of Medical Science, Yazd, Iran;
authors.forename: Mojgan
authors.initials: M
authors.lastname: Karimi-Zarchi
authors.forename: Azamsadat
authors.initials: A
authors.lastname: Mousavi
authors.forename: Mitra Modares
authors.initials: MM
authors.lastname: Gilani
authors.forename: Esmat
authors.initials: E
authors.lastname: Barooti
authors.forename: Ashrafosadat
authors.initials: A
authors.lastname: Miratashi-Yazdi
authors.forename: Atefe
authors.initials: A
authors.lastname: Dehghani
keywords: Cervical cancer; Quality of life; conservative; early stage; fertility preservation