Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

Sexual and Reproductive Outcomes in Early Stage Cervical Cancer Patients after Excisional Cone as a Fertility-sparing Surgery: An Italian Experience

Authors
Francesco Fanfani 1
Fabio Landoni 2
Maria Gagliardi 3
Anna Fagotti 4
Eleonora Preti 2
Maria Moruzzi 3
Giorgia Monterossi 3
Giovanni Scambia 3
1 Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
2 Division of Gynecology, European Institute of Oncology, Milan, Italy
3 Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome, Italy
4 Division of Minimally Invasive Gynecological Surgery, Maria Hospital-University of Perugia, Terni, Italy
Abstract
Background: The purpose of this study was to analyze the quality of life in terms of sexual and reproductive outcome in patients suffering from early stage cervical cancer, submitted to an excisional cone as fertility-sparing treatment. Methods: A multicenter retrospective analysis about specific dimensions of physical, psychological, reproductive and sexual functions after a cold-knife conization plus pelvic laparoscopic lymphadenectomy was conducted at Division of Gynecologic Oncology, Catholic University of the Sacred Heart, Rome-Italy and at Division of Gynecology, European Institute of Oncology, Milan-Italy. The aim of this study was twofold. It aimed to analyze the quality of life in patients submitted to minimally invasive surgery and to compare these data with radical trachelectomy. Results: Twenty-three patients with an average age of 30 years decided to participate in this study. After the treatment, all women (100%) had regular menstruation, 7 (30.4%) had increased not invalidating dysmenorrhea; 1 (4.4%) experienced a cervical stenosis; 6 among 10 patients that tried to conceive (60%) obtained one spontaneous pregnancy; 4 more (40%) underwent in vitro fertilization and embryo transfer and only 1 of them (25%) was successful. About sexual assessment, 1 patient (4.4%) had trouble in lubricating, 3 (13%) had anxiety about performance, 6 (26.1%) complained of dyspareunia which was resolved within 3 subsequent months. All patients (100%) obtained a complete psychological and physical recovery. Conclusion: This study demonstrated preliminary encouraging data about sexual and reproductive outcome after excisional conization. A comparison with trachelectomy surely needs longer follow-ups, more cases and prospective analyses.
Keywords
Cervical cancer
Conservative approach
Excisional cone
Fertility
sparing surgery
Quality of Life
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Journal of Reproduction & Infertility
Volume 15, Issue 1
Winter 2014
Pages 29-34