title: [Fertility sparing treatment in women affected by cervical cancer larger than 2cm].
abstract: OBJECTIVE
  We report our experience on fertility sparing treatment in young women affected by cervical cancer of more than 2cm.
  
  
  METHODS
  Between July 2012 and February 2014, five patients presenting cervical tumors larger than 2cm (IB1>2cm) (23-35) and wishing to preserve fertility have been treated at our institution. Laparoscopic pelvic and para-aortic lymphadenectomy was performed for all patients. When lymph nodes were free of disease, patients had neoadjuvant chemotherapy followed by surgical conservative treatment.
  
  
  RESULTS
  Four patients underwent a cisplatin based neoadjuvant chemotherapy before conservative surgery: radical trachelectomy or simple trachelectomy. One patient with nodal involvement underwent a 3cycle chemotherapy followed by concurrent radiochemotherapy. Hematologic toxicity grade 3 was observed in one patient leading to a change of chemotherapy. Two patients showed complete disappearance of tumor and two a partial response to neoadjuvant treatment. After a mean follow up of 20.5months (14-33), no relapse was observed. To date, no pregnancy was obtained.
  
  
  CONCLUSIONS
  Lymph node staging followed by neoadjuvant chemotherapy and radical trachelectomy seems to be a promising treatment scheme for patients with cervical tumors IB1>2cm pN0 seeking parenthood.
authors.affiliation: Hôpital, institut Curie, département de chirurgie, 5248 Paris, France. Electronic address: pablopenap@yahoo.fr.
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Estevez
authors.affiliation: Hôpital, institut Curie, département de chirurgie, 5248 Paris, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Hequet
authors.affiliation: Hôpital, institut Curie, département d'oncologie médicale, 5248 Paris, France.
authors.forename: Coraline
authors.initials: C
authors.lastname: Dubot
authors.affiliation: Hôpital, institut Curie, département de chirurgie, 5248 Paris, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Fourchotte
authors.affiliation: Hôpital, institut Curie, département d'oncologie médicale, 5248 Paris, France.
authors.forename: Thibault
authors.initials: T
authors.lastname: De La Motte Rouge
authors.affiliation: Hôpital, institut Curie, département d'anatomopathologie, 5248 Paris, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Becette
authors.affiliation: Hôpital, institut Curie, département de chirurgie, 5248 Paris, France.
authors.forename: Roman
authors.initials: R
authors.lastname: Rouzier
mesh_terms: D000328:Adult; D059248:Chemoradiotherapy; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D005260:Female; D059247:Fertility Preservation; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D020360:Neoadjuvant Therapy; D013997:Time Factors; D000069339:Trachelectomy / Q000379:methods; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000628:therapy*
keywords: Cancer du col; Cervical cancer; Chimiothérapie néoadjuvante; Fertility sparing treatment; Neoadjuvant chemotherapy; Préservation de la fertilité; Trachelectomy; Trachélectomie