Multicenter research on tumor and pregnancy outcomes in patients with early-stage cervical cancer after fertility-sparing surgery

Wang, Aihong; Cui, Guanyi; Jin, Canhui; Wang, Ying; Tian, Xiaoyu

doi:10.1177/0300060519845974

Cited by 17 publications

(32 citation statements)

References 16 publications

(25 reference statements)

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“…In light of our results, professionals conducting CIN follow-ups should take into account women's specific concerns about fertility and pregnancy planning. As shown in cancer and fertility research [51, 52], the possibility of fertility-sparing approaches to preserve the reproductive potential of women affected by cervical cancer should be discussed with patients.…”

Section: Discussionmentioning

confidence: 99%

When risk becomes illness: The personal and social consequences of cervical intraepithelial neoplasia medical surveillance

et al. 2019

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BackgroundAfter the early detection of cervical intraepithelial neoplasia (CIN), medical surveillance of the precancerous lesions is carried out to control risk factors to avoid the development of cervical cancer.ObjectiveTo explore the effects of medical surveillance on the personal and social lives of women undergoing CIN follow-up and treatment.MethodologyA generic qualitative study using a poststructuralist perspective of risk management was carried out in a gynecology clinic in a public hospital of the Galician Health Care System (Spain). Participants were selected through purposive sampling. The sample consisted of 21 women with a confirmed diagnosis of CIN. Semistructured interviews were recorded and transcribed, and a thematic analysis was carried out, including researcher triangulation to verify the results of the analysis.FindingsTwo main themes emerged from the participants’ experiences: CIN medical surveillance encounters and risk management strategies are shaped by the biomedical discourse, and the effects of “risk treatment” for patients include (a) profound changes expected of patients, (b) increased patient risk management, and (c) resistance to risk management. While doctors’ surveillance aimed to prevent the development of cervical cancer, women felt they were sick because they had to follow strict recommendations over an unspecified period of time and live with the possibility of a life-threatening disease. Clinical risk management resulted in the medicalization of women’s personal and social lives and produced great uncertainty.ConclusionsThis study is the first to conceptualize CIN medical surveillance as an illness experience for patients. It also problematizes the effects of preventative practices in women’s lives. Patients deal with great uncertainty, as CIN medical surveillance performed by gynecologists simultaneously trivializes the changes expected of patients and underestimates the effects of medical recommendations on patients’ personal wellbeing and social relations.

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Section: Discussionmentioning

confidence: 99%

When risk becomes illness: The personal and social consequences of cervical intraepithelial neoplasia medical surveillance

et al. 2019

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“…A previous study showed that radical/ subradical trachelectomy is a safe and effective fertilitysparing approach for young women with early cervical cancer. 23 Post-surgery pregnancy rates could be as high as 78.26% (54/69) and all patients had good pregnancy outcomes. In this study, approximately 13.25% (11/83) of patients received subradical trachelectomy.…”

Section: Discussionmentioning

confidence: 87%

<p>Survival After Abdominal Q-M Type B versus C2 Radical Hysterectomy for Early-Stage Cervical Cancer</p>

Chen¹,

Wang²,

Liu³

et al. 2019

CMAR

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These authors contributed equally to this workPurpose: To evaluate the survival outcomes of abdominal Q-M type B and type C2 radical hysterectomy (RH) for early-stage (IA1 (lymphovascular invasion)-IIA2) cervical cancer. Patients and methods: Based on this multicenter, retrospective cohort study on the clinical diagnosis and treatment for cervical cancer in China (Four C), the survival outcomes of abdominal type B and type C2 RH for early-stage cervical cancer were compared under real-world and matched cohort study conditions. Results: In total, 46,313 cases were included in the Four C database, among whom 20,018 underwent abdominal type B or type C2 RH. In the real-world study, no differences were found in the 5-year overall survival (OS) between the type B group (n=15,471) and type C2 group (n=4547), but the 5-year disease-free survival (DFS) was lower in the type C2 group (82.1 vs 84.8%, hazard ratio: 1.144). Based on the inclusion criteria, 9135 cases were included and the type C2 group (n=1818) was found to have a lower 5-year OS and DFS (OS: 89.5 vs 92.0%, hazard ratio: 1.393; DFS: 84.3 vs 87.4%, hazard ratio: 1.342). Subsequently, 1799 cases from each group were matched and the type C2 group had a lower 5-year DFS (84.6 vs 88.4%, hazard ratio: 1.332). Upon further analysis of the subgroups, the type C2 group had a lower 5-year OS and DFS (OS: 90.3 vs 93.8%, hazard ratio: 1.522; DFS: 85.2 vs 89.4%, hazard ratio: 1.439). Conclusion: Q-M type B RH could be used for the treatment of stage IA1 (lymphovascular invasion)-IIA2 cervical cancer.

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“…A total of 68 studies were included in this study. Tables 2 , 3 , 4 , 5 , 6 show the data on 3592 patients based on surgical treatment ( 37 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 110 , 111 , 112 ).…”

Section: Resultsmentioning

confidence: 99%

A systematic review of the reproductive and oncologic outcomes of fertility-sparing surgery for early-stage cervical cancer

Nezhat¹,

Erfani²,

Nezhat³

2022

J Turkish German Gynecol Assoc

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In this review, we aim to evaluate the current literature on reproductive and oncologic outcomes after fertility-sparing surgery for early-stage cervical cancer (stage IA1-IB1). This is a systematic review of the existing literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist to report on fertility-sparing surgery and its outcomes in early-stage cervical cancer. Outcomes of interest were subsequent clinical pregnancy rate, reproductive outcomes, and cancer recurrence outcomes. Included in this systematic review were 68 studies encompassing 3,592 patients who underwent fertility-sparing surgery. Of these, reproductive outcomes were reported in 1096 pregnancies. The mean clinical pregnancy rate was 53.2%. Those who underwent vaginal radical trachelectomy had the highest clinical pregnancy rate (67.5%). The mean live birth rate was 67.8% in our study. Twenty-one percent of pregnancies after fertility-sparing surgery required assisted reproductive technology. The mean cancer recurrence rate was 3.2%, and the cancer death rate was 0.6% after a median follow-up period of 40.1 months with no statistically significant difference across surgical approaches. Offering fertility-sparing surgery in early-stage cervical cancer is reasonable. Highest clinical pregnancy rate is associated with vaginal radical trachelectomy. Moreover oncologic outcomes of minimally invasive approaches were comparable with abdominal approaches. We encourage detailed preoperative counseling and multidisciplinary approach to achieve best outcomes.

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Multicenter research on tumor and pregnancy outcomes in patients with early-stage cervical cancer after fertility-sparing surgery

Cited by 17 publications

References 16 publications

When risk becomes illness: The personal and social consequences of cervical intraepithelial neoplasia medical surveillance

When risk becomes illness: The personal and social consequences of cervical intraepithelial neoplasia medical surveillance

<p>Survival After Abdominal Q-M Type B versus C2 Radical Hysterectomy for Early-Stage Cervical Cancer</p>

A systematic review of the reproductive and oncologic outcomes of fertility-sparing surgery for early-stage cervical cancer

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