Unit:
ΠΜΣ Παθολογία της ΚύησηςLibrary of the School of Health Sciences
Author:
Pandraklakis Anastasios
Supervisors info:
Νικόλαος Παπαντωνίου, Ομότιμος Καθηγητής, Ιατρική, ΕΚΠΑ
Δημήτριος Κασσάνος, Ομότιμος Καθηγητής, Ιατρική, ΕΚΠΑ
Χαράλαμπος Χρέλιας, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Original Title:
Μαιευτικά δεδομένα και αποτελέσματα μετά απο συντηρητική αντιμετώπιση και διατήρηση γονιμότητας σε αρχόμενο καρκίνο του τραχήλου της μήτρας
Translated title:
Obstetrical outcomes after conservative management and fertility sparing treatments in early cervical cancer
Summary:
Introduction: Women nowadays, due to socioeconomic reasons, tend to postpone parenthood until their mid-thirties. This age group however has the highest prevalence of cervical cancer. Fortunately, advances in modern medicine have allowed patients with early stage cervical cancer (IA – IIA1) to preserve their fertility potential with similar oncologic efficacy to the classic treatments. These conservative methods, also known as Fertility Sparing Surgeries (FSS), include the Cone Resection/Large Loop Excision of the Transformation Zone (LLETZ), the Vaginal Trachelectomy (VT), the Vaginal Radical Trachelectomy (RT), the Abdominal RT (laparotomic -ART, laparoscopic, robot assisted - Minimal Invasive-MIRT) and the Neo-Adjuvant Chemotherapy followed by FSS (NACT).
Methods: Our review of the literature included 2895 women with early cervical cancer of whom 2676 underwent FSS (219 excluded for oncologic reasons).
Results: Almost half of these patients (48.4%) attempted to become pregnant and 54.4% achieved at least one pregnancy either spontaneously or with the help of Assisted Reproduction Technologies. Data revealed that 65.8% of these pregnancies resulted in live births, whereas 44.6% of them were preterm. The main cause of preterm births in this subpopulation is the postoperative cervical length restriction that consequently leads to cervical incompetence and ascending infections that eventually lead to (clinical or subclinical) chorioamnionitis.
Conclusions: Aim of this review is to assess the possible reasons of the high prematurity rates in women with early stage cervical cancer and to offer guidance on the prevention and management of these high-risk pregnancies, as official standardized protocols have yet to be established.
Main subject category:
Health Sciences
Keywords:
Fertility sparing surgery, Trachelectomy, Early cervical cancer, Lap* trachelectomy", Robotic trachelectomy, Radical trachelectomy, Abdominal trachelectomy, Neoadjuvant chemo* cervical, Conization, Cone resection cervix, Fertility cervical cancer, Prematurity after trachelectomy, Pregnancy complications trachelectomy, Obstetrical management cervical cancer
Number of references:
419
