Gynecologic Oncology, Amsterdam University Medical Centre, Amsterdam, Centre for Gynecologic Oncology, Amsterdam, the Netherlands.
Gynecologic Oncology, Amsterdam University Medical Centre, Amsterdam, Centre for Gynecologic Oncology, Amsterdam, the Netherlands.
Best Pract Res Clin Obstet Gynaecol. 2021 Sep;75:82-100. doi: 10.1016/j.bpobgyn.2021.01.010. Epub 2021 Feb 20.
The current review provides a literature overview of studies assessing the oncological and fertility outcomes of treatment with neo-adjuvant chemotherapy followed by fertility-sparing surgery in patients with cervical cancer >2 cm. Six cohort studies were included showing severe heterogeneity regarding patient selection, chemotherapy regimen, and surgical approach. In total, 111 patients were studied, with overall favorable characteristics. Patients were on average 29 years old, had a tumor of 36 mm, no lymph node metastasis, and response to chemotherapy. In approximately 5-year follow-up, the recurrence rate was 13% (0%-21%) and overall death rate 2.7% (0%-10%). Three patients were alive with recurrent disease (2.7% and 0%-11%). Of the 111 patients, 90 underwent successful fertility-sparing treatment (83%). Roughly one-third conceived and one-fourth had a healthy live-born child. More research is essential to determine proper selection criteria for fertility-sparing treatment of cervical cancer >2 cm and the optimal treatment management.
本综述提供了文献综述，评估了新辅助化疗后行保留生育功能手术治疗 >2 cm 宫颈癌患者的肿瘤学和生育结局。纳入了 6 项队列研究，这些研究在患者选择、化疗方案和手术方法方面存在严重的异质性。总共研究了 111 名患者，这些患者具有良好的总体特征。患者平均年龄 29 岁，肿瘤大小为 36mm，无淋巴结转移，对化疗有反应。在大约 5 年的随访中，复发率为 13%（0%-21%），总死亡率为 2.7%（0%-10%）。3 名患者（2.7%，0%-11%）存活且疾病复发。111 名患者中，90 名成功接受了保留生育功能治疗（83%）。大约三分之一的患者受孕，四分之一的患者有健康的活产儿。需要进一步的研究来确定 >2 cm 宫颈癌保留生育功能治疗的适当选择标准和最佳治疗管理。
