Conservative surgical treatment of early cervical cancer in nulliparous patients. Meta-analysis

Abstract

Introduction. Relevance in the Republic of Moldova, in the last five years over 1500 women was diagnosed with cervical cancer, and over 1000 lost their lives. Cervical cancer is placed third among cancers of women and first among women aged 25-44. Worldwide cervical cancer mortality rates they are substantially smaller than the incidence, with an incidence mortality rate of 50,3%. Aim of the study. This study proposes to analyze the published literature characterizing the oncological results of the nulliparous patients with early cervical cancer, who want to maintain fertility and menstrual function to conceive a pregnancy. Materials and methods.. The research of the articles is designed in such a way that the obtained results to contain safe dates effectuated on smaller lots, being combined, they present the sum of studies on this subject, and the definitive conclusions are obtained. Results. 20 scientific works including the study of patients with early cervical cancer. The results obtained to add 4568 patients which have been exposed to the conization intervention and include 3 scientific works and 17 are involved in the treatment of radical trachelectomy. 946 patients are included in the conization group; 845 (89.3%) stage IA1, 2 (11,7%) stage IA2. In the radical trachelectomy group there are 3539 patients, 924 (26.1%) stage IA1, 1046 (29.5%) stage IA2, 1522 (43%) stage IB1, 48 (13%) stage IB2. Of 16 studies that have been reported fertile results are 47.9% (397/829), birth rate with 59.5% (514/864), premature birth rate 61.9% (302/488) and abortion rate in the second trimester was 71.8% (26/362). Conclusions. This article focuses on current options for conservative surgery in early cervical cancer associated with long-term oncologic efficacy, keeping reproductive function. Treatment that determines fertility conservation, radical trachelectomy is favourable, and carefully selected women can maintain fertility and get a pregnancy.