ORGAN-PRESERVING TREATMENT OF EARLY CERVICAL CANCER
Objective. To develop an algorithm for the comprehensive examination of patients with early cervical cancer for future organ-preserving treatment, to evaluate oncological and reproductive results of this method.
Materials and methods. The study was based on data of 54 patients aged 22 to 43 years (median – 31 years) with the following stages of cervical cancer: IA1 (LVSI+) — 6 (11%) patients, IA2 — 14 (26%) persons, IB1 — 30 (56%) women, IIA1 — 4 (7%) patients.The patients were distributed according to the type of the performed fertility-spearing surgery: 10 (19%) patients had been performed ultraminimal radical surgeries (cervical amputation, pelvic lymphadenectomy), 37 (68%) women– radical abdominal trachelectomies, 7 (13%) patients had undergone complex modality treatment.Statistical processing of the study results was carried out in accordance with the evidence-based mediciner equirements.
Results. An algorithm for complex examination including a set of diagnostic measures, the sequence of conducting them, and the rules of decision making for female candidates for organ-preserving treatment was developed.In 87% of patients selected at the preoperative stage, the organ was preserved.The adjusted and the overall 3-year survival
was 100% (SE 2.0%) with the median follow-up duration of 22.1 months (9.5 months to 75.2 months).The reproductive outcomes were evaluatedin 19 patients. Pregnancy occurred in three (16%) women, in two (11%) women it ended in childbirth, one patient had a miscarriage in the gestation period of 16 weeks.
Conclusion.Application of the comprehensive survey and organ-preserving technologies developed for treating patients with cervical cancer at IA1-IB1, IIA1 stages developed in this study allows achieving high oncological and reproductive outcomes, retain the organ in 87% of patients,and improve the quality of life of the treated women.