Cervical conisation plus radical bilateral pelvic lymph node dissection as conservative treatment for cervical cancer IB1: Case report and review of the literature
DOI:
https://doi.org/10.18597/rcog.25Keywords:
Uterine cervix neoplasms, fertility preservation, conisation, gynaecological surgical procedures, lymph node excisionAbstract
Objective: To describe the case of a patient with cervical cancer FIGO stage IB1 taken to conisation and pelvic lymphadenectomy with the aim of preserving fertility, and to conduct a search in the literature regarding indications, effectiveness and safety of this procedure in terms of obstetric and oncologic outcomes.
Materials and methods: We present the case of a 26-year old female patient seen at the Julio Enrique Medrano SaludCoop Clinic (Barranquilla, Colombia), a high-complexity institution that serves a population belonging to the contributory regime of the social security system. The patient was diagnosed with infiltrating cervical carcinoma stage IB1. She was taken to cervical cone biopsy plus pelvic lymph node dissection in order to preserve fertility. Two years into follow-up she achieved a term pregnancy, and 48 months later she is disease-free. An online search was conducted of the literature published until July 2015, with no language restriction, using the key words Uterine Cervical Neoplasms, Fertility Preservation, Conization, Gynaecologic Surgical Procedures and Lymph Node Excision in the Medline, Embase, CINAHL and Cochrane databases and in the bibliographic references of retrieved studies.
Results: Overall, 9 articles were identified: 8 cohort studies and 1 case report. Cervical conisation plus bilateral radical pelvic lymphadenectomy is a less radical, safer and effective procedure for the conservative management of low-risk cervical cancer. A relapse rate of 2.84 % has been reported in patients subjected to conisation, pregnancy is achieved in 38 % of cases and, of those, 70.2 % come to term.
Conclusions: Cervical conisation plus bilateral radical pelvic lymphadenectomy may be a management option for patients with low-risk, early-stage cervical cancer who wish to preserve their fertility.
Author Biographies
Robinson Fernández-Mercado
Ginecólogo-Oncólogo; docente de posgrado, Universidad Libre y Universidad Metropolitana de Barranquilla (Colombia).
Jairo Amaya-Guío
Álvaro González-Rubio
Erika Muñoz-Amariz
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