Early-stage cervical cancer in reproductive-aged women: 10 years of experience of a tertiary care center

• Main Author: Bivar,Leonor
• Publication Date: 2020
• Other Authors: Trocado,Vera, Fernandes,Daniel, Patrício,Vanda, Petiz,Almerinda
• Format: Article
• Language: eng
• Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
• Download full: http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302020000100004
• topic: Early stage cervical cancer; Reproductive-aged women; Trachelectomy

Overview and aims: Early-stage cervical cancer has a good prognosis, with survival rates at 5 years &gt;90%. However, while offering the potential for disease cure, treatment often results in the loss of future fertility or impacts the ovarian function. The aim of this study is to examine the characteristics, treatment and survival outcomes of reproductive-aged women with early-stage cervical cancer at a tertiary care center over a period of 10 years. Study design, Population and Methods: Data from patients with early stage cervical cancer (< stage IB1< 2cm) aged 40 years and younger treated between 2008 and 2017 at that institute were collected. Variables selected included patient demographics, tumor information, treatment types, obstetrical outcomes and survival outcomes. Descriptive analysis and a binary logistic regression model were performed using SPSS v. 23.0. Results: In 2008-2017 period, a total of 75 women with stage IA1IB1 (< 2 cm) cervical cancer and ≤40 years at diagnosis were treated. Sixty five percent (49) were squamous carcinomas and 29% (22) adenocarcinomas. Surgical treatment was the first-line option for all patients: 8% (6) cervical conization, 7% (5) trachelectomy with pelvic laparoscopic lymphadenectomy, 21% (16) simple extrafascial hysterectomy and 64% (48) radical hysterectomy. Overall, irrespective of the type of surgical treatment, 75% (56) had conservation of ovaries. In a multivariable analysis, squamous cell carcinoma histology was a predictor of ovarian conservation (adjusted OR 11.03, 95% CI 2.66-45,61, p 0.001) on radical hysterectomy. Three of the patients submitted to trachelectomy got pregnant, one of which had a preterm delivery. Recurrence of the disease was reported in 4% (3) of the cases, only one case of mortality was disease-related. Conclusions: Despite the small case series, our study found a high proportion of reproductive-aged women with early-stage cervical cancer submitted to ovary-sparing surgical treatment, with promising results concerning to recurrence, mortality and pregnancy rates.