The number of patients given neoadjuvant chemotherapy (NAC) followed by fertility-sparing surgery in cervical cancer is still scarce. Only a few centres perform these procedures, and thus, such procedures remain largely in the experimental stage. Patients that do not fulfil the criteria for standard fertility-sparing procedure can be included in studies with NAC followed by fertility-sparing procedure. We must consider that both oncological and pregnancy outcomes are important. Patients with only microscopic disease after NAC are apparently the best candidates for fertility-sparing surgery. Current data are not sufficient to identify the optimal procedure after NAC [abdominal radical trachelectomy (ART) or vaginal radical trachelectomy (VRT) or simple trachelectomy]. Some evidence suggests that pregnancy outcome is better after simple trachelectomy as compared with VRT or ART. Long-term results regarding oncological outcome for this concept are still lacking. Adjuvant chemotherapy in patients with histopathological risk factors (lymphovascular space involvement (LVSI), macroscopic residual disease) would decrease a risk of recurrence.

• MeSH
• Sentinel Lymph Node Biopsy MeSH
• Adult MeSH
• Gynecologic Surgical Procedures methods   MeSH
• Combined Modality Therapy MeSH
• Humans MeSH
• Neoplasm Recurrence, Local prevention & control   MeSH
• Magnetic Resonance Imaging MeSH
• Uterine Cervical Neoplasms pathology   surgery   MeSH
• Neoadjuvant Therapy methods   MeSH
• Antineoplastic Combined Chemotherapy Protocols therapeutic use   MeSH
• Carcinoma, Squamous Cell pathology   surgery   MeSH
• Pregnancy MeSH
• Pregnancy Outcome MeSH
• Treatment Outcome MeSH
• Fertility Preservation methods   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH

Cervical cancer is one of the most common cancers in women worldwide. Because it often affects women of childbearing age (19-45 years), fertility-sparing surgery is an important issue. The article reviews current viable fertility-sparing options with a special focus on trachelectomy, including vaginal radical trachelectomy, abdominal radical trachelectomy and simple trachelectomy. Neoadjuvant chemotherapy is also discussed. Finally, the decision to proceed with fertility-sparing treatment should be a patient-driven process.

• Keywords
• cervical cancer, chemotherapy, pregnancy outcome, trachelectomy,
• Publication type
• Journal Article MeSH
• Review MeSH