Book contents
- 50 Big Debates in Gynecologic Oncology
- 50 Big Debates in Gynecologic Oncology
- Copyright page
- Contents
- Contributors
- Section I Perioperative Management
- Section II Screening, Prevention, and Early Diagnosis
- Section III Ovarian Cancer
- Section IV Endometrial Cancer
- Section V Cervical Cancer
- Debate 42A Is there a Role for Minimally Invasive Radical Hysterectomy for Management of Cervical Cancer?
- Debate 42B Is there a Role for Minimally Invasive Radical Hysterectomy for Management of Cervical Cancer?
- Debate 43A Is Radical Surgery or Parametrectomy Needed for Early-stage FIGO IA2 and Microscopic IB1 Cervical Cancer?
- Debate 43B Is Radical Surgery or Parametrectomy Needed for Early-stage FIGO IA2 and Microscopic IB1 Cervical Cancer?
- Debate 44A What is the Best Management Option for Young Women with Stage IB2 Cervical Cancer Who Wish to Preserve Fertility?
- Debate 44B What is the Best Management Option for Young Women with Stage IB2 Cervical Cancer Who Wish to Preserve Fertility?
- Debate 45A Should Adjuvant Hysterectomy be Performed for Patients with Locally Advanced Cervical Cancer Treated with Concurrent Chemoradiotherapy?
- Debate 45B Should Adjuvant Hysterectomy be Performed for Patients with Locally Advanced Cervical Cancer Treated with Concurrent Chemoradiotherapy?
- Debate 46A What is the Best Initial Treatment for Stage IB3 to IIB Cervical Cancer?
- Debate 46B What is the Best Initial Treatment for Stage IB3 to IIB Cervical Cancer?
- Debate 47A Is there a Role for Immunotherapy in Treatment of Cervical Cancer?
- Debate 47B Is there a Role for Immunotherapy in Treatment of Cervical Cancer?
- Section VI Vaginal and Vulvar Cancer
- Index
- References
Debate 44A - What is the Best Management Option for Young Women with Stage IB2 Cervical Cancer Who Wish to Preserve Fertility?
Abdominal Radical Trachelectomy
from Section V - Cervical Cancer
Published online by Cambridge University Press: 20 July 2023
Book contents
- 50 Big Debates in Gynecologic Oncology
- 50 Big Debates in Gynecologic Oncology
- Copyright page
- Contents
- Contributors
- Section I Perioperative Management
- Section II Screening, Prevention, and Early Diagnosis
- Section III Ovarian Cancer
- Section IV Endometrial Cancer
- Section V Cervical Cancer
- Debate 42A Is there a Role for Minimally Invasive Radical Hysterectomy for Management of Cervical Cancer?
- Debate 42B Is there a Role for Minimally Invasive Radical Hysterectomy for Management of Cervical Cancer?
- Debate 43A Is Radical Surgery or Parametrectomy Needed for Early-stage FIGO IA2 and Microscopic IB1 Cervical Cancer?
- Debate 43B Is Radical Surgery or Parametrectomy Needed for Early-stage FIGO IA2 and Microscopic IB1 Cervical Cancer?
- Debate 44A What is the Best Management Option for Young Women with Stage IB2 Cervical Cancer Who Wish to Preserve Fertility?
- Debate 44B What is the Best Management Option for Young Women with Stage IB2 Cervical Cancer Who Wish to Preserve Fertility?
- Debate 45A Should Adjuvant Hysterectomy be Performed for Patients with Locally Advanced Cervical Cancer Treated with Concurrent Chemoradiotherapy?
- Debate 45B Should Adjuvant Hysterectomy be Performed for Patients with Locally Advanced Cervical Cancer Treated with Concurrent Chemoradiotherapy?
- Debate 46A What is the Best Initial Treatment for Stage IB3 to IIB Cervical Cancer?
- Debate 46B What is the Best Initial Treatment for Stage IB3 to IIB Cervical Cancer?
- Debate 47A Is there a Role for Immunotherapy in Treatment of Cervical Cancer?
- Debate 47B Is there a Role for Immunotherapy in Treatment of Cervical Cancer?
- Section VI Vaginal and Vulvar Cancer
- Index
- References
Summary
The radical trachelectomy procedure is now recognized as a “standard of care” option for young women with early-stage cervical cancer who wish to preserve fertility. However, the oncologic safety of this approach has mostly been validated for small lesions measuring <2 cm. The optimal management for patients with larger lesions who wish to preserve fertility remains unsettled and there is currently no standard of care. There are essentially two alternatives: either to proceed with upfront radical trachelectomy or neo-adjuvant chemotherapy (NACT) followed by fertility-sparing surgery (FSS). The balance between oncologic outcomes and surgical morbidity versus fertility and obstetrical outcomes need to be carefully balanced and addressed. We wish to present to the readers with arguments for and against both options in the hopes that it will help clinicians decide which is the best option for their individual patients.
- Type
- Chapter
- Information
- 50 Big Debates in Gynecologic Oncology , pp. 265 - 267Publisher: Cambridge University PressPrint publication year: 2023
References
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van Kol KGG, et al. Abdominal radical trachelectomy versus chemotherapy followed by vaginal radical trachelectomy in stage 1B2 (FIGO 2018) cervical cancer. A systematic review on fertility and recurrence rates. Gynecol Oncol 2019;155:515–521.Google Scholar
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Plante, M, et al. FIGO 2018 stage IB2 (2–4 cm) Cervical cancer treated with Neo-adjuvant chemotherapy followed by fertility Sparing Surgery (CONTESSA); Neo-Adjuvant Chemotherapy and Conservative Surgery in Cervical Cancer to Preserve Fertility (NEOCON-F). A PMHC, DGOG, GCIG/CCRN and multicenter study. Int J Gynecol Cancer 2019;29:969–975.CrossRefGoogle Scholar