Neo-adjuvant chemotherapy in fertility sparing cervical cancer treatment

Abstract The current review provides a literature overview of studies assessing the oncological and fertility outcomes of treatment with neo-adjuvant chemotherapy followed by fertility sparing surgery in patients with cervical cancer \u003e2 cm. Six cohort studies were included showing severe heterogeneity regarding patient selection, chemotherapy regimen and surgical approach. In total 111 patients were studied, with overall favorable characteristics. Patients were on average 29 years old, had a tumor of 36 mm, no lymph node metastasis and response to chemotherapy. In about 5-year follow-up, the recurrence rate was 13% (0%-21%) and overall death rate 2.7% (0%-10%). Three patients were alive with recurrent disease (2.7%, 0-11%). Of the 111 patients, 90 underwent successful fertility sparing treatment (83%). Roughly one third conceived and one fourth had a healthy live-born child. More research is essential to determine proper selection criteria for fertility sparing treatment of cervical cancer \u003e2 cm and the optimal treatment management.