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. 2022 Jul;126(1):37-47.
doi: 10.1002/jso.26899.

Brazilian Society of Surgical Oncology consensus on fertility-sparing surgery for cervical cancer

Glauco Baiocchi  1 , Audrey Tieko Tsunoda  2 , Gustavo Guitmann  3 , Marcelo Andrade Vieira  4 , Paulo Henrique Zanvettor  5 , Janiceli Blanca Carlotto Hablich Silvestre  6 , Marcelo Henrique Santos  7 , Raquel de Maria Maués Sacramento  8 , Eliel Oliveira de Araujo  9 , Roberto Heleno Lopes  9 , Deraldo Falcao  5 , Andre Lopes  10 , Ronaldo Schmidt  7 , Jorge Soares Lyra  11 , Herbert Ives Barretto Almeida  12 , William Augusto Casteleins  13 , Georgia Fontes Cintra  14 , Lucas Adalberto Geraldi Zanini  15 , Rosilene Jara Reis  16 , Eid Gonçalves Coelho  17 , Fábio Roberto Fin  18 , Viviane Rezende  19 , Thais Dvulatk Marques Pançan  6 , Sabas Carlos Vieira  20 , Jeancarllo Sousa Silva  21 , Manoel Rodrigues de Andrade  22 , Vandre Cabral Gomes Carneiro  23 , Tariane Friedrich Foiato  24 , Guilherme Fonteles Ritt  25 , Gustavo Castro Ianaze  26 , Renato Moretti-Marques  27 , Carlos Eduardo Mattos Cunha Andrade  7 , Luiza Freitas Maciel  3 , Daniel Lourenço Lira  28 , Gustavo Mendes Medeiros  29 , Amanda Lira Santos Leite  30 , Guilherme Oliveira Cucolicchio  31 , Muhamed Read Ali Tayeh  32 , Ricardo Pedrini Cruz  33 , Gustavo Ziggiatti Guth  34 , Renato Mazon Lina Verde Leal  35 , Valentino Antonio Magno  36 , Francisco Carlos Oliveira Lopes  37 , Gustavo Andreazza Laporte  16 , Alexandre Pupo-Nogueira  38 , Aldo Vieira Barros  30 , Juliano Rodrigues da Cunha  39 , Suzana Arenhart Pessini  36 , Joana Froes Braganca  40 , Higino Felipe Figueiredo  28 , Carlos Manoel Bulcão Loureiro  41 , Ronald Enrique Delgado Bocanegra  42 , Renato José Affonso  43 , Paulo Henrique de Souza Fernandes  39 , Heber Salvador Castro Ribeiro  1 , Thales Paulo Batista  44 , Alexandre Ferreira Oliveira  9 , Reitan Ribeiro  2
Affiliations

Brazilian Society of Surgical Oncology consensus on fertility-sparing surgery for cervical cancer

Glauco Baiocchi et al. J Surg Oncol. 2022 Jul.

Abstract

Objective: Several controversies remain on conservative management of cervical cancer. Our aim was to develop a consensus recommendation on important and novel topics of fertility-sparing treatment of cervical cancer.

Methods: The consensus was sponsored by the Brazilian Society of Surgical Oncology (BSSO) from March 2020 to September 2020 and included a multidisciplinary team of 55 specialists. A total of 21 questions were addressed and they were assigned to specialists' groups that reviewed the literature and drafted preliminary recommendations. Further, the coordinators evaluated the recommendations that were classified by the level of evidence, and finally, they were voted by all participants.

Results: The questions included controversial topics on tumor assessment, surgical treatment, and surveillance in conservative management of cervical cancer. The two topics with lower agreement rates were the role of minimally invasive approach in radical trachelectomy and parametrial preservation. Additionally, only three recommendations had <90% of agreement (fertility preservation in Stage Ib2, anti-stenosis device, and uterine transposition).

Conclusions: As very few clinical trials have been developed in surgery for cervical cancer, most recommendations were supported by low levels of evidence. We addressed important and novel topics in conservative management of cervical cancer and our study may contribute to literature.

Keywords: cervical cancer; conservative management; fertility-sparing surgery; radical trachelectomy; simple trachelectomy.

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References

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