Reproductive, obstetrical and oncological outcomes of fertility-sparing treatment for cervical cancer according to the FIGO 2018 staging system: A systematic review

Eur J Surg Oncol. 2025 Jan;51(1):109359. doi: 10.1016/j.ejso.2024.109359. Epub 2024 Nov 7.

Abstract

Objective: We assessed reproductive, obstetrical, and oncological outcomes in patients who underwent fertility-sparing treatment by including studies that adhere to the FIGO 2018 staging system.

Methods: Data on recurrence, mortality, pregnancy rate, live birth rate, and preterm delivery rate were collected.

Results: In patients with stages IA1, IA2, and IB1, the recurrence rate was 4.7 % and the death rate was 0.6 %. For patients with stage IB2, the recurrence rate was 12.1 % and the death rate was 3.2 %. Pregnancy rates for conization/simple trachelectomy and radical trachelectomy were 61.7 % and 50 %, respectively. A higher live birth rate (84.4 % vs 58.6 %), and lower preterm birth rate (18.3 % vs 33.3 %) were observed in patients undergoing conization compared to radical trachelectomy.

Conclusion: We found a recurrence rate of 4.7 % in patients with stage less than or equal to IB1 and 12.1 % in those with stage IB2. A higher rate of preterm delivery was observed in patients who underwent radical trachelectomy.

Keywords: Cervical cancer; Conization; Fertility-sparing surgery; Trachelectomy.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Conization* / methods
  • Female
  • Fertility Preservation* / methods
  • Humans
  • Live Birth
  • Neoplasm Recurrence, Local* / epidemiology
  • Neoplasm Staging*
  • Pregnancy
  • Pregnancy Rate
  • Premature Birth / epidemiology
  • Trachelectomy* / methods
  • Uterine Cervical Neoplasms* / pathology
  • Uterine Cervical Neoplasms* / surgery