Neo-adjuvant chemotherapy in fertility-sparing cervical cancer treatment

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. (c) 2021 Published by Elsevier Ltd.

Automated summary

The review shows that patients with cervical cancer >2 cm who received neo-adjuvant chemotherapy followed by fertility-sparing surgery had overall favorable characteristics, with approximately 83% successfully undergoing fertility-sparing treatment, about one-third conceiving, and one-fourth having a healthy live-born child.