A Case for the Conservative Management of Stage IA Cervical Cancer

SIMPLE SUMMARY: Cervical cancer remains a major public health concern despite available screening and vaccination. Early-stage disease is frequently treated with radical surgery that has greater operative complications and results in a loss of fertility. Cervical cancer is most frequently diagnosed in pre-menopausal women, making fertility preservation a frequent concern. Additionally, in early-stage disease, there is mounting evidence that radical surgery is not necessary to achieve optimal oncologic outcomes. Using less radical surgical techniques improves patient surgical recovery, avoids long-term complications of surgery, and allows women to retain their fertility if they desire. This editorial presents the data for conservative management of early-stage cervical cancer. ABSTRACT: Cervical cancer remains a significant public health concern within the United States and across the world. Cervical cancer is most frequently diagnosed in women between the ages of 35 and 44 and therefore affects a younger patient population than many other cancers. The management of early-stage disease has frequently utilized radical hysterectomy with the associated increased surgical morbidity, without clear evidence of any benefits. In stage IA disease, there are retrospective pathologic data supporting the safety of conservative surgery and lymphadenectomy over radical hysterectomy. There are also emerging prospective studies supporting conservative management. This editorial presents the evidence for conservative management of stage IA cervical cancer by reviewing the existing retrospective studies as well as the ongoing prospective studies.