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Statements

Subject Item
n2:RIV%2F00216208%3A11130%2F14%3A10293104%21RIV15-MSM-11130___
rdf:type
skos:Concept n11:Vysledek
rdfs:seeAlso
http://dx.doi.org/10.1016/j.ygyno.2014.08.021
dcterms:description
Objective. 28 women under 35 years with early-stage cervical cancer and strong desire for fertility preservation that do not fulfil standard criteria for fertility-sparing surgery (tumour larger than 2 cm or with deep of infiltration more than half of stroma) were included in prospective study. Methods. Dose-dense neoadjuvant chemotherapy (NAC) was performed on all 28 patients in 10-day intervals: cisplatin plus ifosfamide in squamous cell cancer (15 women-53.6%) or cisplatin plus doxorubicin in adenocarcinoma (13 women-46.3%). Patients underwent laparoscopic lymphadenectomy and vaginal simple trachelectomy after NAC. Patients with positive lymph nodes or inadequate free surgical margins underwent radical hysterectomy. Results. No residual disease was found in 6 women (21.4%), microscopic disease was observed in 11 women (39.3%) and macroscopic tumour in was observed in 11 women (39.3%). Ten women (35.7%) lost fertility. Four women (20%) after fertility-sparing surgery recurred, two died of the disease (10%). Fertility was spared in 20 (71.4%) women and 10 of them became pregnant (50%). Eight women delivered ten babies (6 term and four preterm deliveries). There were two miscarriages in second trimester (in one woman) and one in first trimester. One woman underwent four unsuccessful cycles of IVF, one failed to become pregnant and one recurred too early. Two women underwent chemoradiotherapy for recurrence and lost chance for pregnancy. Conclusions. Downstaging by NAC in IB1 and IB2 cervical cancer before fertility-sparing surgery is still an experimental procedure, but shows some promise. Long-term results in relation to oncological outcome for this concept are still needed. Objective. 28 women under 35 years with early-stage cervical cancer and strong desire for fertility preservation that do not fulfil standard criteria for fertility-sparing surgery (tumour larger than 2 cm or with deep of infiltration more than half of stroma) were included in prospective study. Methods. Dose-dense neoadjuvant chemotherapy (NAC) was performed on all 28 patients in 10-day intervals: cisplatin plus ifosfamide in squamous cell cancer (15 women-53.6%) or cisplatin plus doxorubicin in adenocarcinoma (13 women-46.3%). Patients underwent laparoscopic lymphadenectomy and vaginal simple trachelectomy after NAC. Patients with positive lymph nodes or inadequate free surgical margins underwent radical hysterectomy. Results. No residual disease was found in 6 women (21.4%), microscopic disease was observed in 11 women (39.3%) and macroscopic tumour in was observed in 11 women (39.3%). Ten women (35.7%) lost fertility. Four women (20%) after fertility-sparing surgery recurred, two died of the disease (10%). Fertility was spared in 20 (71.4%) women and 10 of them became pregnant (50%). Eight women delivered ten babies (6 term and four preterm deliveries). There were two miscarriages in second trimester (in one woman) and one in first trimester. One woman underwent four unsuccessful cycles of IVF, one failed to become pregnant and one recurred too early. Two women underwent chemoradiotherapy for recurrence and lost chance for pregnancy. Conclusions. Downstaging by NAC in IB1 and IB2 cervical cancer before fertility-sparing surgery is still an experimental procedure, but shows some promise. Long-term results in relation to oncological outcome for this concept are still needed.
dcterms:title
Oncological and pregnancy outcomes after high-dose density neoadjuvant chemotherapy and fertility-sparing surgery in cervical cancer Oncological and pregnancy outcomes after high-dose density neoadjuvant chemotherapy and fertility-sparing surgery in cervical cancer
skos:prefLabel
Oncological and pregnancy outcomes after high-dose density neoadjuvant chemotherapy and fertility-sparing surgery in cervical cancer Oncological and pregnancy outcomes after high-dose density neoadjuvant chemotherapy and fertility-sparing surgery in cervical cancer
skos:notation
RIV/00216208:11130/14:10293104!RIV15-MSM-11130___
n3:aktivita
n16:I
n3:aktivity
I
n3:cisloPeriodika
2
n3:dodaniDat
n8:2015
n3:domaciTvurceVysledku
n9:7462395 n9:5371236 n9:8504571 n9:4745531 n9:9354433 n9:7298471 n9:2066408
n3:druhVysledku
n18:J
n3:duvernostUdaju
n14:S
n3:entitaPredkladatele
n13:predkladatel
n3:idSjednocenehoVysledku
34554
n3:idVysledku
RIV/00216208:11130/14:10293104
n3:jazykVysledku
n4:eng
n3:klicovaSlova
Cervical cancer; Fertility outcome; Pregnancy outcome; Trachelectomy; Neoadjuvant chemotherapy; Fertility-sparing surgery
n3:klicoveSlovo
n6:Neoadjuvant%20chemotherapy n6:Cervical%20cancer n6:Pregnancy%20outcome n6:Fertility%20outcome n6:Fertility-sparing%20surgery n6:Trachelectomy
n3:kodStatuVydavatele
US - Spojené státy americké
n3:kontrolniKodProRIV
[5341E696AF1D]
n3:nazevZdroje
Gynecologic Oncology
n3:obor
n15:FD
n3:pocetDomacichTvurcuVysledku
7
n3:pocetTvurcuVysledku
7
n3:rokUplatneniVysledku
n8:2014
n3:svazekPeriodika
135
n3:tvurceVysledku
Matěcha, Jan Lisý, Jiří Halaška, Michael Škapa, Petr Pluta, Marek Rob, Lukáš Robová, Helena
n3:wos
000345605200008
s:issn
0090-8258
s:numberOfPages
4
n12:doi
10.1016/j.ygyno.2014.08.021
n19:organizacniJednotka
11130