Conservative management of cervical cancer: Current status and obstetrical implications

Abstract

Recent advances in screening and early diagnosis have decreased cervical cancer incidence and mortality rates in high-resource settings. The postponement of childbearing, combined with an increased number of cervical cancer survivors, has yielded new paradigms in patient care. In recent years, radical surgery has been challenged as the standard of care for early-stage cervical cancer owing to its significant morbidity and fertility impairment. Attention has been directed to assessing more conservative procedures that can reduce treatment-induced morbidity without compromising oncologic safety and reproductive potential of patients with early-stage disease. In those with more advanced disease, neoadjuvant chemotherapy followed by conservative surgery has also been considered. These conservative treatment modalities including cervical conization, simple trachelectomy, and simple hysterectomy have been studied in various settings. In this chapter, we discuss the role of conservative surgery in the management of cervical cancer and the resulting obstetrical outcomes.

Keywords: Cervical cancer; Conization; Conservative surgery; Fertility-sparing surgery; Simple hysterectomy; Simple trachelectomy.