Academic Journal
Survival After Fertility-Sparing Surgery for Early-Stage Cervical Cancer Compared With Nonsparing Surgery: A Nationwide Comparative Study.
| Τίτλος: | Survival After Fertility-Sparing Surgery for Early-Stage Cervical Cancer Compared With Nonsparing Surgery: A Nationwide Comparative Study. |
|---|---|
| Συγγραφείς: | Wolswinkel JT; Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the Netherlands., Zusterzeel PLM; Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the Netherlands., Smits A; Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the Netherlands., Siebers AG; Palga, the Dutch Nationwide Pathology Databank, Houten, the Netherlands., Wenzel HHB; Department of Research & Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands., Bekkers RLM; Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the Netherlands.; Department of Obstetrics and Gynaecology, Medical Centre and GROW School for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands.; Department of Obstetrics and Gynaecology, Catharina Hospital, Eindhoven, the Netherlands., Beltman JJ; Department Obstetrics and Gynaecology, Leiden University Medical Centre, Leiden, the Netherlands., Lok CAR; Centre for Gynaecological Oncology Amsterdam (CGOA), Antoni van Leeuwenhoek/Netherlands Cancer Institute, Amsterdam, the Netherlands., Mom CH; Centre for Gynaecological Oncology Amsterdam (CGOA), Academic Medical Centre, Cancer Centre Amsterdam, Amsterdam, the Netherlands., van Trommel NE; Centre for Gynaecological Oncology Amsterdam (CGOA), Antoni van Leeuwenhoek/Netherlands Cancer Institute, Amsterdam, the Netherlands., Zweemer RP; Department of Gynaecological Oncology, University Medical Centre Utrecht, Utrecht Cancer Centre, Utrecht, the Netherlands., Maurits JSF; Radboud University Medical Centre, IQ Health Science Department, Nijmegen, the Netherlands., Ten Eikelder MLG; Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the Netherlands. |
| Πηγή: | JCO oncology practice [JCO Oncol Pract] 2026 Jun; Vol. 22 (6), pp. 1040-1048. Date of Electronic Publication: 2025 Sep 23. |
| Τύπος έκδοσης: | Journal Article; Comparative Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: American Society of Clinical Oncology Country of Publication: United States NLM ID: 101758685 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2688-1535 (Electronic) Linking ISSN: 26881527 NLM ISO Abbreviation: JCO Oncol Pract Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Alexandria, Va. : American Society of Clinical Oncology, [2020]- |
| Ιατρικοί όροι (MeSH): | Uterine Cervical Neoplasms*/surgery , Uterine Cervical Neoplasms*/mortality , Uterine Cervical Neoplasms*/pathology , Fertility Preservation*/methods, Hysterectomy/methods ; Humans ; Female ; Adult ; Retrospective Studies ; Neoplasm Staging ; Middle Aged ; Young Adult ; Adolescent ; Netherlands ; Disease-Free Survival |
| Περίληψη: | Purpose: The oncologic safety of fertility-sparing surgery in young women with early-stage cervical cancer is largely based on retrospective data from small series, highlighting the need for larger studies to validate its safety. Methods: We performed a nation-wide retrospective matched cohort study of all patients age 18-45 years with Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) 2018 stage IA1 to IB2 cervical cancer who underwent fertility-sparing surgery (FSS; cone biopsy, large loop excision of the transformation zone, or [radical] trachelectomy) between 2000 and 2022 in the Netherlands (fertility-sparing group). These patients were matched 1:2 with women who had a (radical) hysterectomy for early-stage cervical cancer (hysterectomy group). Patients were matched for pretreatment FIGO 2018 stage, histology, and lymph vascular space invasion. We compared data on recurrence-free survival, disease-free survival, and overall survival (OS) between the fertility-sparing group and the hysterectomy-group. Results: In total, 1,446 patients were included: 482 treated with FSS and 964 with a (radical) hysterectomy; 57.5% had stage 1A1 or 1A2, and 42.5% had IB1 or IB2 cervical cancer. The median follow-up was 8.9 years (IQR, 4.4-13.7). During the study period, 4.8% of patients developed a recurrence: 7.1% in the fertility-sparing group and 3.6% in the hysterectomy group (hazard ratio [HR], 2.21 [95% CI, 1.38 to 3.56]).The OS in both groups did not differ (HR, 1.06 [95% CI, 0.62 to 1.80]). Conclusion: Women treated with FSS had a significantly higher recurrence rate than patients who had the uterus completely removed. However, since the increased recurrence rate did not affect OS, fertility-sparing surgery appears to be a potentially safe treatment option. |
| Entry Date(s): | Date Created: 20250923 Date Completed: 20260616 Latest Revision: 20260616 |
| Update Code: | 20260617 |
| DOI: | 10.1200/OP-25-00131 |
| PMID: | 40986799 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 2688-1535 |
|---|---|
| DOI: | 10.1200/OP-25-00131 |