Tumor Size and Oncological Outcomes in Patients with Early Cervical Cancer Treated by Fertility Preservation Surgery : A Multicenter Retrospective Cohort Study
Gil-Ibañez, Blanca (Hospital Universitario 12 de Octubre (Madrid))
Gil-Moreno, Antonio 1965- (Hospital Universitari Vall d'Hebron)
Torne, Aureli (Hospital Clínic i Provincial de Barcelona)
Martin-Jimenez, Angel (Hospital Universitari Son Llàtzer (Palma de Mallorca, Balears))
Gorostidi, Mikel (Hospital Universitario de Donostia.(Sant Sebastià, País Basc))
Zapardiel, Ignacio (Hospital Universitario 12 de Octubre (Madrid))
Díaz-Feijoo, Berta (Hospital Clínic i Provincial de Barcelona)
Universitat Autònoma de Barcelona

Date:	2022
Abstract:	As cervical cancer is increasingly diagnosed in women who still intend to have children, fertility-sparing surgery is arising as a treatment option for those women with early-stage cervical cancer. The aim of this study was to analyze surgical, oncological and obstetrical outcomes of fertility-sparing surgery in early cervical cancer in Spain. In our study, the tumor size was the most important negative prognostic factor in fertility-sparing surgery (FSS) in cervical cancer. Selection criteria for fertility preservation should be rigorous, especially for patients with a tumor > 2 cm, due to the worse oncological outcomes associated with such tumors. Patients with an early cervical cancer tumor > 2 cm and a desire for pregnancy should be advised against primary FSS. Background: The aim of this study was to analyze the impact of tumor size > 2 cm on oncological outcomes of fertility-sparing surgery (FSS) in early cervical cancer in a Spanish cohort. Methods: A multicenter, retrospective cohort study of early cervical cancer (stage IA1 with lymphovascular space invasion -IB1 (FIGO 2009)) patients with gestational desire who underwent FSS at 12 tertiary departments of gynecology oncology between 01/2005 and 01/2019 throughout Spain. Results: A total of 111 patients were included, 82 (73. 9%) with tumors < 2 cm and 29 (26. 1%) with tumors 2-4 cm. Patients' characteristics were balanced except from lymphovascular space invasion. All were intraoperative lymph node-negative. Median follow-up was 55. 7 and 30. 7 months, respectively. Eleven recurrences were diagnosed (9. 9%), five (6. 0%) and six (21. 4%) (p < 0. 05). The 3-year progression-free survival (PFS) was 95. 7% (95%CI 87. 3-98. 6) and 76. 9% (95% CI 55. 2-89. 0) (p = 0. 011). Only tumor size (<2 cm vs. 2-4 cm) was found to be significant for recurrence. After adjusting for the rest of the variables, tumor size 2-4 cm showed a Hazard Ratio of 5. 99 (CI 95% 1. 01-35. 41, p = 0. 036). Conclusions: Tumor size ≥ 2 cm is the most important negative prognostic factor in this multicenter cohort of patients with early cervical cancer and gestational desire who underwent FSS in Spain.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Early cervical cancer ; Fertility-sparing surgery ; Tumor size
Published in:	Cancers, Vol. 14 (april 2022) , ISSN 2072-6694

DOI: 10.3390/cancers14092108
PMID: 35565238

10 p, 814.8 KB

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