Multicenter research on tumor and pregnancy outcomes in patients with early-stage cervical cancer after fertility-sparing surgery

OBJECTIVE: To investigate tumor and pregnancy outcomes after fertility-sparing surgery for cervical cancer. METHODS: A total of 83 patients with cervical cancer who received fertility-sparing surgery at 10 gynecologic cancer research centers in Henan Province were enrolled from January 2010 to June 2016. Clinical data and follow-up results were collected. Of them, 78 had cervical squamous carcinoma and five had cervical adenocarcinoma. International Federation of Gynecology and Obstetrics (2009) staging showed that 26 patients had stage IA1, 11 had stage IA2, and 46 had stage IBI. Seventy-two patients underwent radical trachelectomy and retroperitoneal lymphadenectomy, whereas 11 underwent subradical trachelectomy and retroperitoneal lymphadenectomy. Moreover, 17 patients received one to two courses of preoperative neoadjuvant chemotherapy and five received two to four courses of postoperative chemotherapy. Eighty-three patients were followed up postoperatively (median follow-up duration, 36.2 months). RESULTS: With regard to tumor outcomes, one (1.2%) patient showed recurrence following fertility-sparing surgery. In 69 patients with planned pregnancy after treatment, 54 had 58 pregnancies, including 42 full-term births and eight premature births. Seventy-nine patients were satisfied with their quality of life. CONCLUSIONS: Radical/subradical trachelectomy is safe and effective as fertility-sparing surgery for young patients with early cervical cancer, with good pregnancy outcomes.