Evolution in Fertility-Preserving Options for Early-Stage Cervical Cancer: Radical Trachelectomy, Simple Trachelectomy, Neoadjuvant Chemotherapy

Plante, Marie MD

International Journal of Gynecological Cancer:
doi: 10.1097/IGC.0b013e318295906b
Review Article
Abstract

Abstract: Fertility preservation is of paramount importance for young women diagnosed with early-stage cervical cancer. The radical trachelectomy procedure was developed to preserve uterine/reproductive function. The procedure has evolved significantly over the last 25 years. This review focuses on the various surgical techniques (vaginal, abdominal, laparoscopic, and robotic), highlighting advantages and disadvantages of each in relation to their respective obstetrical and oncologic outcomes. A trend toward even more conservative surgery (simple trachelectomy/large cone) has recently been advocated for patients with low-risk early lesions. Conversely, the option of neoadjuvant chemotherapy followed by fertility-preserving surgery for patients with larger-size lesions has also been proposed. Emerging data are presented.

Author Information

Gynecologic Oncology Division Centre Hospitalier Universitaire de Québec L’Hôtel-Dieu de Québec, Laval University, Quebec City, Quebec, Canada.

Address correspondence and reprint requests to Marie Plante, MD, L’Hôtel-Dieu de Québec Gynecologic Oncology Service 11 Côte du Palais Quebec City, Quebec, Canada G1R 2J6. E-mail: marie.plante@crhdq.ulaval.ca.

The author declares no conflict of interest.

Received February 26, 2013

Accepted March 22, 2013

© 2013 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.