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Reproductive outcomes after fertility-sparing surgery for cervical cancer - results of the multicenter FERTISS study.
Fricová, Lenka; Kommoss, Stefan; Scambia, Giovanni; Ferron, Gwenael; Kocián, Roman; Harter, Philipp; Anchora, Luigi Pedone; Bats, Anne-Sophie; Novàk, Zoltán; Walter, Christina Barbara; Raspagliesi, Francesco; Lambaudie, Eric; Bahrehmand, Kiarash; Andress, Jürgen; Klát, Jaroslav; Pasternak, Jana; Matylevich, Olga; Szeterlak, Nina; Minár, Lubos; Heitz, Florian; Capîlna, Mihai Emil; Runnebaum, Ingo; Cibula, David; Sláma, Jirí.
Afiliación
  • Fricová L; Department of Obstetrics, Gynecology and Neonatology First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague 128 08, Czech Republic.
  • Kommoss S; Department of Women's Health, Tuebingen University Hospital, Tuebingen, Germany; Gynecology, Diakonie-Klinikum Schwäbisch Hall gGmbH, Schwäbisch Hall 74523, Germany.
  • Scambia G; Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart Rome, Rome 00168, Italy.
  • Ferron G; Claudius Regaud Institute-University Cancer Institute, Toulouse, 31300, France.
  • Kocián R; Department of Obstetrics, Gynecology and Neonatology First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague 128 08, Czech Republic. Electronic address: Roman.Kocian@vfn.cz.
  • Harter P; Department of Gynecology & Gynecologic Oncology, Evangelical Clinic Essen Mitte, Essen 45136, Germany.
  • Anchora LP; Department of Women and Child Health, Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart Rome, Rome 00168, Italy.
  • Bats AS; Gynecologic and Breast Oncologic Surgery Department, Georges Pompidou European Hospital, Paris, France; University Paris Cité, Paris, 75015, France.
  • Novàk Z; Department of Gynecology, Hungarian National Institute of Oncology, Budapest 1122, Hungary; Doctoral School of Clinical Medicine, University of Szeged, Hungary.
  • Walter CB; Department of Women's Health, Tuebingen University Hospital, Tuebingen 72076, Germany.
  • Raspagliesi F; Fondazione IRCCS Istituto Nazionale Tumori Milan, Milan 20133, Italy.
  • Lambaudie E; Department of Surgical Oncology, Institut Paoli-Calmettes, Marseille 13009, France.
  • Bahrehmand K; Department of Gynecology, Hungarian National Institute of Oncology, Budapest 1122, Hungary; Doctoral School of Clinical Medicine, University of Szeged, Hungary.
  • Andress J; Department of Women's Health, Tuebingen University Hospital, Tuebingen 72076, Germany.
  • Klát J; Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, Palacky University, University Hospital Olomouc, Olomouc 779 00, Czech Republic.
  • Pasternak J; Department of Women's Health, Tuebingen University Hospital, Tuebingen 72076, Germany.
  • Matylevich O; Gynecologic Oncology Department, N.N. Alexandrov National Cancer Centre of Belarus, Minsk 223040, Belarus.
  • Szeterlak N; Department of Gynecology, Breast Center, Red Cross Clinic Munich Women's Clinic, Munich 80634, Germany.
  • Minár L; Department of Gynecology and Obstetrics, University Hospital Brno and Masaryk University, Brno 602 00, Czech Republic.
  • Heitz F; Department of Gynecology & Gynecologic Oncology, Evangelical Clinic Essen Mitte, Essen 45136, Germany.
  • Capîlna ME; First Obstetrics and Gynecology Clinic, "George Emil Palade" University of Medicine, Pharmacy, Science and Technology Târgu Mureș, Târgu Mureș 540136, Romania.
  • Runnebaum I; Department of Gynecology and Reproductive Medicine, University Hospital Jena, Jena 07747, Germany.
  • Cibula D; Department of Obstetrics, Gynecology and Neonatology First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague 128 08, Czech Republic.
  • Sláma J; Department of Obstetrics, Gynecology and Neonatology First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague 128 08, Czech Republic.
Gynecol Oncol ; 190: 179-185, 2024 Aug 27.
Article en En | MEDLINE | ID: mdl-39197417
ABSTRACT

INTRODUCTION:

Fertility-sparing treatment (FST) for patients with cervical cancer intends to achieve oncologic outcomes comparable to those after radical treatment while maximizing reproductive outcomes, including the ability to conceive and minimizing the risk of prematurity.

METHODOLOGY:

International multicentre retrospective FERTISS study focused on patients treated with FST analysed timing of FST relative to pregnancy, conception attempts and methods, abortion rates, prophylactic procedures reducing the risk of severe prematurity, pregnancy duration, and delivery mode.

RESULTS:

Of the 733 patients treated at 44 centres in 13 countries, 49.7% attempted to conceive during median follow-up of 72 months and 22.6% (166/733) patients achieved a successful pregnancy. Success rate was significantly higher after non-radical surgery (63.2%; 122/193) compared to radical trachelectomy (25.7%; 44/171, p < 0.001). Available perinatological data shows that 89.5% (111/124) of the patients became pregnant naturally. There was no significant difference in the abortion rate in the first pregnancy nor delivery success rates between non-radical and radical procedures patients. Preterm delivery (<38 weeks gestation) occurred more frequently after radical than non-radical procedures (76.5% vs. 57.7%, p = 0.15). Almost all patients (97.3%; 73/75) who underwent regular ultrasound cervicometry in pregnancy with subsequent prophylactic procedures delivered a live fetus, compared to 30.6% (15/49) women without such management, p < 0.001.

CONCLUSION:

Patients who underwent non-radical surgery had significantly higher pregnancy rates. Most pregnancies resulted in a viable fetus, but radical trachelectomy led to a higher rate of preterm births in the severe prematurity range. Half of the patients did not attempt pregnancy after FST.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Gynecol Oncol Año: 2024 Tipo del documento: Article País de afiliación: República Checa Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Gynecol Oncol Año: 2024 Tipo del documento: Article País de afiliación: República Checa Pais de publicación: Estados Unidos