Fertility-sparing surgery in cervical cancer

Since the first radical hysterectomy and the development of the Pap smear, cervical cancer diagnosis and treatment has seen great advances. Early-stage, microscopically invasive lesions are increasingly being identified, allowing more conservative approaches to management, including fertility-sparing procedures. In appropriately selected patients, cure rates are equivalent with significant reductions in morbidity and preserved child-bearing potential. Laparoscopic and robotic technologies are improving and patients are benefiting from innovations such as sentinel lymph node mapping, neoadjuvant chemotherapy and modified surgical procedures. Surgical procedures include radical vaginal or abdominal trachelectomy, simple trachelectomy and cervical conization. Pregnancy outcomes are promising and continually improving. Selection criteria are being refined, reflecting improved knowledge of risk factors for recurrence while considering the benefits for individual patients. © TOUCH BRIEFINGS 2011.