Neoadjuvant chemotherapy followed by conization to spare fertility in cases of locally advanced cervical cancer: A case report and review of the literature

Mol Clin Oncol. 2016 Oct;5(4):411-416. doi: 10.3892/mco.2016.972. Epub 2016 Aug 1.

Abstract

The average age when cervical cancer is diagnosed is decreasing, resulting in a larger proportion of patients seeking fertility preservation. Therefore, a less radical approach that aims to preserve the potential for fertility during the treatment of cervical carcinoma is crucial. The present study reported a case of a patient with stage IB2 cervical cancer who exhibited pathological complete regression to neoadjuvant chemotherapy (NACT). This patient underwent deep cervical conization and laparoscopic lymphadenectomy to preserve her fertility. The patient gave birth at 29 weeks of gestation and exhibited no recurrent disease until May 2016 (72 months after surgery). This is the first, to the best of our knowledge, IB2 case treatment by NACT, followed by conization plus lymphadenectomy, producing favorable oncological and obstetrical outcome. The present study, together with data from a limited number of published articles, offers a new perspective in the preservation of fertility in young women with cervical cancer. Additional studies are required in a selected population.

Keywords: cervical cancer; conization; fertility sparing; neoadjuvant chemotherapy; pregnancy.