ArticleGynecologic oncology2025
Evaluation of efficacy and fertility after nonradical surgical therapy (extra fascial hysterectomy or cone biopsy, with pelvic lymphadenectomy) for stage IA1, IA2, and IB1 cervical cancer (GOG-0278).
Article in Gynecologic oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cancer and fertility management: FIGO best practice advice.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Guideline
- De-escalating radical surgery for select FIGO Stage I cervical cancer.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Review
- Advances in the Surgical Management of Cervical Cancer.Cancers · 2026Review
- Major clinical advances in gynecologic cancer in 2025: from de-escalation strategies to precision therapies beyondJournal of gynecologic oncology · 2026Review
- Fertility-sparing surgery with neoadjuvant chemotherapy in early and locally advanced cervical cancer: A clinical protocol.PloS one · 2026Article
- Review
- Long-Term Survival in Patients With Low-Risk Cervical Cancer After Simple, Modified, or Radical Hysterectomy.JAMA network open · 2025Article
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Authors and funding
22 authors.
Funding
Abstract
objectiveTo estimate the efficacy and perioperative morbidity of nonradical surgery (simple hysterectomy [SH] or cone biopsy [CB] plus pelvic lymphadenectomy [PLND] and to report pregnancy outcomes after CB.
methodsProspective international study with 3-year follow-up of patients with stage IA1 (lymphovascular space invasion-positive) to IB1 (≤2 cm) cervical cancer stratified by fertility preservation (CB) or none (SH) (both with PLND). Criteria included ≤10 mm stromal invasion and negative margins on loop electrosurgical excision procedure or CB.
resultsWe enrolled 224 patients: 72 (32 %) CB and 152 (68 %) SH. Of those, 23 patients (5 CB; 18 SH) were deemed ineligible or refused surgery; 14 % had stage IA1, 28 % stage IA2, and 58 % stage IB1 disease; and 65 % had squamous carcinoma, 32 % adenocarcinoma, and 3 % adenosquamous carcinoma. We found adverse events (grade ≥ 3) within 30 days of surgery in 1 CB and 7 SH patients. In the CB group, 31 patients desired pregnancy during the study and 16 pregnancies occurred. Of those, 4 were spontaneous abortions, 3 were preterm deliveries, and 9 were full-term deliveries. After a median follow-up of 37 months (range 0.2-93 months), 3 patients in the CB group experienced recurrence (3-year recurrence-free survival, 94.8 %, and subsequently underwent hysterectomy), compared to none in the SH group.
conclusionsNon-radical surgery for early-stage cervical cancer appears safe, with low morbidity. Patients treated by CB and PLND can achieve successful pregnancies. Recurrences in the cervix after CB can occur and require diligent surveillance to attain high cure rates.
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