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Reproductive outcomes after fertility-sparing surgery for cervical cancer - results of the multicenter FERTISS study
L. Fricová, S. Kommoss, G. Scambia, G. Ferron, R. Kocián, P. Harter, LP. Anchora, AS. Bats, Z. Novàk, CB. Walter, F. Raspagliesi, E. Lambaudie, K. Bahrehmand, J. Andress, J. Klát, J. Pasternak, O. Matylevich, N. Szeterlak, L. Minář, F. Heitz, ME....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, multicentrická studie
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- nádory děložního čípku * chirurgie MeSH
- předčasný porod prevence a kontrola etiologie epidemiologie MeSH
- retrospektivní studie MeSH
- těhotenství MeSH
- trachelektomie metody MeSH
- výsledek těhotenství MeSH
- zachování plodnosti * metody MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
INTRODUCTION: Fertility-sparing treatment (FST) for patients with cervical cancer intends to achieve oncologic outcomes comparable to those after radical treatment while maximizing reproductive outcomes, including the ability to conceive and minimizing the risk of prematurity. METHODOLOGY: International multicentre retrospective FERTISS study focused on patients treated with FST analysed timing of FST relative to pregnancy, conception attempts and methods, abortion rates, prophylactic procedures reducing the risk of severe prematurity, pregnancy duration, and delivery mode. RESULTS: Of the 733 patients treated at 44 centres in 13 countries, 49.7% attempted to conceive during median follow-up of 72 months and 22.6% (166/733) patients achieved a successful pregnancy. Success rate was significantly higher after non-radical surgery (63.2%; 122/193) compared to radical trachelectomy (25.7%; 44/171, p < 0.001). Available perinatological data shows that 89.5% (111/124) of the patients became pregnant naturally. There was no significant difference in the abortion rate in the first pregnancy nor delivery success rates between non-radical and radical procedures patients. Preterm delivery (<38 weeks gestation) occurred more frequently after radical than non-radical procedures (76.5% vs. 57.7%, p = 0.15). Almost all patients (97.3%; 73/75) who underwent regular ultrasound cervicometry in pregnancy with subsequent prophylactic procedures delivered a live fetus, compared to 30.6% (15/49) women without such management, p < 0.001. CONCLUSION: Patients who underwent non-radical surgery had significantly higher pregnancy rates. Most pregnancies resulted in a viable fetus, but radical trachelectomy led to a higher rate of preterm births in the severe prematurity range. Half of the patients did not attempt pregnancy after FST.
Claudius Regaud Institute University Cancer Institute Toulouse 31300 France
Department of Gynecology and Gynecologic Oncology Evangelical Clinic Essen Mitte Essen 45136 Germany
Department of Gynecology and Reproductive Medicine University Hospital Jena Jena 07747 Germany
Department of Gynecology Breast Center Red Cross Clinic Munich Women's Clinic Munich 80634 Germany
Department of Gynecology Hungarian National Institute of Oncology Budapest 1122 Hungary
Department of Surgical Oncology Institut Paoli Calmettes Marseille 13009 France
Department of Women's Health Tuebingen University Hospital Tuebingen 72076 Germany
Department of Women's Health Tuebingen University Hospital Tuebingen Germany
Doctoral School of Clinical Medicine University of Szeged Hungary
Fondazione IRCCS Istituto Nazionale Tumori Milan Milan 20133 Italy
Gynecologic and Breast Oncologic Surgery Department Georges Pompidou European Hospital Paris France
Gynecology Diakonie Klinikum Schwäbisch Hall gGmbH Schwäbisch Hall 74523 Germany
Citace poskytuje Crossref.org
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- $a Fricová, Lenka $u Department of Obstetrics, Gynecology and Neonatology First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague 128 08, Czech Republic
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