Fertility-Preserving Surgeries in Carcinoma Cervix – What Is the Current Evidence?

Abstract

Cervical cancer is the most common cancer in India. Fourteen percent of the patients diagnosed withcervical cancer in India are under the age of 40. As more women decide to delay childbearing, thenumber of nulliparous women with cervical cancer may increase. Early-stage cervical cancer has beentraditionally treated with radical hysterectomy or radical radiotherapy. Both forms of therapy will notpreserve fertility. In 1987, a French surgeon, Professor Dargent, developed a fertility-sparing surgicalapproach for treating cervical cancer in nulliparous women. This procedure included vaginal radicaltrachelectomy and laparoscopic pelvic lymphadenectomy for early cervical cancer. Ten years later,abdominal radical trachelectomy was introduced into practice. Many new studies have come upcombining neoadjuvant chemotherapy with radical trachelectomy for larger tumors and also studieshave described less radical procedures like conisation for treating carcinoma cervix. With thesetechniques, now women with cervical cancer have a chance to retain their fertility. Through this paper,we are reviewing the current evidence for fertility preserving surgeries in carcinoma cervix.