Marta Heras

Oncological safety of fertility preservation treatment in ovarian cancer: A Spanish multicenter study

AbstractObjectiveTo assess the safety of fertility‐sparing treatments for early‐stage ovarian cancer in women younger than 40 years old.MethodsWe performed a retrospective multicenter study including women aged 18–40 years diagnosed with early‐stage (FIGO I–II) ovarian cancer in 55 Spanish hospitals, from January 2010 to December 2019. Benign and borderline tumors were excluded, as well as advanced stages (FIGO III–IV). All perioperative characteristics and follow‐up data were collected and analyzed. Standard staging surgery (SSS) was compared with fertility‐sparing surgery (FSS) in terms of oncological outcomes.ResultsIn all, 366 women were included; 327 (89.3%) were stage I. Among all patients, 216 (59%) underwent SSS and 150 (41%) FSS. Up to 208 (56.8%) patients did not have children, but only 12 (3.2%) had oocyte preservation before treatment. Patients in the FSS group compared with the SSS group showed a non‐significant difference in recurrences (8% vs. 9.3%, respectively; P < 0.711) and deaths (1.3% vs. 4.8%, respectively; P = 0.211) during the follow‐up. No significant differences were found between epithelial and non‐epithelial ovarian cancer both in recurrences (7.1% vs. 8.8%, respectively; P = 0.771) and in deaths (1.4% vs. 1.3%, respectively; P = 1) among patients who underwent FSS.ConclusionFSS seems a safe option for treatment of early‐stage ovarian cancer in patients who want to preserve fertility, either for epithelial and non‐epithelial histology.

Robotic radical trachelectomy in early stage cervical cancer

Radical trachelectomy represents an alternative for early stage cervical cancer in patients who want to preserve fertility. This procedure can be performed by vaginal, open or minimal invasive approach. The robotic approach may offer some advantages, especially for the surgeon´s ergonomics. Since the evidence is still scarce, larger studies are needed. Our objective is to present a retrospective review of our experience with robotic radical trachelectomy. Descriptive study carried out in Clinico San Carlos University Hospital, Madrid, Spain. We included all our patients with early stage cervical cancer that wished to preserve fertility, from 2023 to 2022. The surgery included bilateral pelvic lymphadenectomy followed by radical trachelectomy and cervical cerclage after confirmation of absence of nodal metastasis. Demographic data of the study population, perioperative and oncological outcomes were analyzed. Seven patients who underwent radical robotic trachelectomy were studied. Median patient age was 30 (range 23-35) years. Median body mass index was 24 (range 19-28). Tumor histology was squamous cell carcinoma in 57% (4) and adenocarcinoma in 43% (3) of the patients. Median surgical time was 285 (range 247-315) min. The median of pelvic nodes obtained was 15 (range 12-40). Two postoperative complications were observed. One patient tried to conceived and had preterm labor. One patient died of the disease. In selected cases, robotic radical trachelectomy is a safe option for patients that wish to preserve their fertility with similar rates of oncological safety and complications than open procedures and a shorter recovery time.