Fertility-Sparing Surgery for Early-Stage Cervical Cancer: A Systematic Review of Oncologic and Obstetric Outcomes

Abstract

Introduction: For young women with early-stage cervical cancer who desire future fertility, fertility-sparing surgery such as radical trachelectomy has been developed as an alternative to radical hysterectomy. This review assesses the outcomes of this approach.

Methods: A systematic review of large case series and cohort studies was conducted. We included studies of women who underwent radical trachelectomy (abdominal or vaginal) for Stage IA2-IB1 cervical cancer. Primary outcomes were cancer recurrence rates and subsequent pregnancy outcomes.

Results: The review of over 50 studies showed that the cancer recurrence and mortality rates after radical trachelectomy were comparable to those reported for radical hysterectomy in similar-stage disease. A significant number of women were able to conceive after the procedure, although they were at high risk for preterm birth and second-trimester loss.

Discussion: In carefully selected patients, radical trachelectomy is an oncologically safe procedure. It provides a valuable option for fertility preservation, but subsequent pregnancies are high-risk and require specialized obstetric care.

Conclusion: Radical trachelectomy is an oncologically safe, fertility-sparing option for women with early-stage cervical cancer.