Fertility-Preserving Surgeries in Carcinoma Cervix – What Is the Current Evidence?

Abstract

Cervical cancer is the most common cancer in India. Fourteen percent of the patients diagnosed with cervical cancer in India are under the age of 40. As more women decide to delay childbearing, the number of nulliparous women with cervical cancer may increase. Early-stage cervical cancer has been traditionally treated with radical hysterectomy or radical radiotherapy. Both forms of therapy will not preserve fertility. In 1987, a French surgeon, Professor Dargent, developed a fertility-sparing surgical approach for treating cervical cancer in nulliparous women. This procedure included vaginal radical trachelectomy and laparoscopic pelvic lymphadenectomy for early cervical cancer. Ten years later, abdominal radical trachelectomy was introduced into practice. Many new studies have come up combining neoadjuvant chemotherapy with radical trachelectomy for larger tumors and also studies have described less radical procedures like conisation for treating carcinoma cervix. With these techniques, now women with cervical cancer have a chance to retain their fertility. Through this paper, we are reviewing the current evidence for fertility preserving surgeries in carcinoma cervix.

Keywords: cervical cancer, nulliparous women, radical hysterectomy, pelvic lymphadenectomy, neoadjuvant chemotherapy