Conservative (Non-Radical) Surgery For Stage Ib1 Cervical Cancer
BEST PRACTICE & RESEARCH CLINICAL OBSTETRICS & GYNAECOLOGY(2021)
摘要
There has been lively debate in recent years following the publi-cation of various retrospective case series and small cohort studies that suggest certain women presenting with International Feder-ation of Gynecology and Obstetrics (FIGO) stage IB1 cervical cancer (pre-2018 revised classification) may be treated by non-radical surgery, either simple hysterectomy or cone biopsy, where fertility preservation is required. A strictly defined histological criterion is necessary for selecting such cases, incorporating tumour dimensions including estimated tumour volume, lympho-vascular space invasion and pelvic lymph node status. Meta-analyses of these studies show that the oncological outcomes are comparable to the excellent results achieved by radical hysterec-tomy and radical trachelectomy. In addition, the fertility and pregnancy outcomes for cases treated by conisation are superior to cases managed by radical trachelectomy. Multi-centre, ethically approved, prospective studies are currently on-going, which will provide better quality evidence in an attempt to contribute to this debate, with the intention of improving outcomes, including quality of life, in women presenting with small-volume stage IB1 cervical cancer. (c) 2021 Published by Elsevier Ltd.
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关键词
Cervical cancer, Fertility, Conisation, Tumour volume, Conservative, Stage IB1
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