ASO Author Reflections: Fertility-Sparing Treatment for Early-Stage Cervical Cancer 2 cm or Larger in Size: A Problem Still Open

Excerpt

The role of fertility-sparing treatments (FST) has become crucial in early-stage cervical cancer (ECC) management considering the increasing age of first pregnancy in Western countries. The guidelines recognize various approaches^1,2 (conization, vaginal trachelectomy, minimally invasive trachelectomy, abdominal trachelectomy, and neoadjuvant chemotherapy combined with conization or trachelectomy) depending on the tumor stage and other risk factors such as histotype and lymph-vascular positivity.³ However, the choice of the best strategy remains an open problem. One of the significant limitations is the size of the tumor. In particular, no consensus exists on the strategy to be adopted in the case of an ECC 2 cm in size or larger. The current orientation of the scientific community comprises groups with a surgical approach and groups using neoadjuvant chemotherapy (NACT), but these approaches are not standardized, and no direct comparison between them is available in the scientific literature. This study aimed to collect the literature evidence regarding the management for this type of patient. …