Conservative Surgery in Early-Stage Cervical Cancer

The standard treatment for women with early-stage cervical cancer (IA2-IB1) is radical hysterectomy (RH) with pelvic lymphadenectomy. In patients interested in preserving fertility, the option of radical trachelectomy (RT) with pelvic lymphadenectomy is a viable option without compromising oncologic outcomes. The standard indications for radical trachelectomy include stage IA2-IB1, squamous carcinoma, adenocarcinoma, or adenosquamous carcinoma, tumors <2 cm, desire for future fertility, and no evidence of metastatic disease. Radical trachelectomy has been shown to be safe and feasible through several surgical approaches. Major intraoperative complications are rare and occur in <1% of patients. The most frequent postoperative complication after radical trachelectomy is cervical stenosis (10%). Regarding obstetric outcomes, approximately 75% of patients are able to maintain their fertility after RT.