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The role of neoadjuvant chemotherapy in fertility-sparing treatment of patients with cervical cancer with tumor sizes over 2 cm

September 19, 2025
862
Obstetrics and Gynecology
Oncology, Hematology
Renkas O.P.
Svintsitsky V.S.
УДК:  618 (618.146-006.6-085.28)
DOI:  10.32471/umj.1680-3051.268951
Keywords :
cervical cancer,
fertility-preserving treatment
Specialities :
Obstetrics and Gynecology
Oncology, Hematology
Resume

Purpose: to evaluate the feasibility, safety, and oncological outcomes in patients with cervical cancer with tumor size >2 cm who received neoadjuvant chemotherapy followed by fertility-sparing treatment.

Materials and methods. From January 2018 to January 2025, 25 patients diagnosed with cervical cancer stage 1B2–ІІА2 (FIGO 2018) were included in the study. The mean age of the patients at diagnosis was 28 years (range 16–36 years). Clinical cases of patients with cervical cancer 2–6 cm who were selected to receive neoadjuvant chemotherapy before fertility-sparing treatment (abdominal radical trachelectomy, vaginal radical trachelectomy, conization with pelvic lymphadenectomy) were analyzed.

Results. Surgical and clinical outcomes have examined together with radiological and pathological findings. 17 patients (68%) had squamous cell carcinoma, 8 patients (32%) had adenocarcinoma, and no cases had adenosquamous carcinoma. The mean tumor size before chemotherapy was 32 mm (range 25–52 mm), and after chemotherapy was 9 mm (range 0–27 mm). Patients received neoadjuvant chemotherapy with cisplatin 70 mg/m2 and paclitaxel 175 mg/m2 or carboplatin AUC5-6 and paclitaxel 175 mg/m2 every 3 weeks. Fertility was successfully preserved in 23 of 25 (96%) patients. One patient had stable disease after three cycles of chemotherapy and was therefore not eligible for fertility-sparing surgery, and another patient had positive lymph nodes verified by histological examination, so she underwent chemoradiation therapy. One of 25 (4%) patients experienced disease recurrence.

Conclusion. Neoadjuvant chemotherapy followed by fertility-sparing surgery may be a feasible and safe option for selected patients with cervical cancer with tumors >2 cm.

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