Fertility-sparing management in cervical cancer: balancing oncologic outcomes with reproductive success

Table 8 Oncologic outcomes of fertility-sparing surgery after NACT (where N > 5 reported)

Study	N who received NACT	Timing of LN assessment (N positive LN)	NACT regimen	Surgical procedure	N recurrence (mos)	N dead of disease (mos)	Median follow up months for entire series (range)
Maneo 2008 [65]	21	After NACT (2)	TIP/TEP x 3	Cone	0^a	0	69 (10–124)
Robova 2010 [132]	15	After NACT (1)	TI/TAx3	ST	3 (−)	1 (−)	76.5 (17–142)
Marchiole 2011 [64]	7	After NACT (0)	TIP/TEP x2-3	VRT	0	0	22 (5–49)
Vercecllino 2012 [133]	6	Before NACT (0)	1-TP 5-TIP	VRT	0	0	30.6 (8–70)
Lanowska 2014 [134]	20	Before NACT (0)	TIP/TP × 2-3	VRT	1 (20)	0	23 (1–88)
Salihi 2015 [131]	11	Before NACT (1)	2 TIP x3 4 ddCP x3 5 wCP x3	Cone	1 (40)	0	58 (13–122)
Total	N = 80				N = 5	N = 1
Crude rates (%)					Recurrence rate = 6.3 %^#	Mortality rate = 1.3 %^#

Abbreviations: NACT neoadjuvant chemotherapy, LN lymph node, ST simple trachelectomy, VRT vaginal radical trachelectomy, TP cisplatin + paclitaxel, TI cisplatin + ifosfamide, TA cisplatin + doxorubicin (for adenocarcinoma), TIP cisplatin + paclitaxel + ifosfamide, TEP cisplatin + paclitaxel + epirubicin (for adenocarcinoma), ddCP dose dense carboplatin + paclitaxel, wCP weekly carboplatin + paclitaxel
^#Crude recurrence and mortality rates among those who successfully underwent fertility sparing surgery, notwithstanding adjuvant treatment received
^a N = 3 patients developed CIN in the residual cervix

ISSN: 2053-6844