{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T15:56:06Z","timestamp":1782921366799,"version":"3.54.5"},"reference-count":17,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"6","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Oncol Pract"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>The oncologic safety of fertility-sparing surgery in young women with early-stage cervical cancer is largely based on retrospective data from small series, highlighting the need for larger studies to validate its safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We performed a nation-wide retrospective matched cohort study of all patients age 18-45 years with F\u00e9d\u00e9ration Internationale de Gyn\u00e9cologie et d\u2019Obst\u00e9trique (FIGO) 2018 stage IA1 to IB2 cervical cancer who underwent fertility-sparing surgery (FSS; cone biopsy, large loop excision of the transformation zone, or [radical] trachelectomy) between 2000 and 2022 in the Netherlands (fertility-sparing group). These patients were matched 1:2 with women who had a (radical) hysterectomy for early-stage cervical cancer (hysterectomy group). Patients were matched for pretreatment FIGO 2018 stage, histology, and lymph vascular space invasion. We compared data on recurrence-free survival, disease-free survival, and overall survival (OS) between the fertility-sparing group and the hysterectomy-group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>In total, 1,446 patients were included: 482 treated with FSS and 964 with a (radical) hysterectomy; 57.5% had stage 1A1 or 1A2, and 42.5% had IB1 or IB2 cervical cancer. The median follow-up was 8.9 years (IQR, 4.4-13.7). During the study period, 4.8% of patients developed a recurrence: 7.1% in the fertility-sparing group and 3.6% in the hysterectomy group (hazard ratio [HR], 2.21 [95% CI, 1.38 to 3.56]).The OS in both groups did not differ (HR, 1.06 [95% CI, 0.62 to 1.80]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Women treated with FSS had a significantly higher recurrence rate than patients who had the uterus completely removed. However, since the increased recurrence rate did not affect OS, fertility-sparing surgery appears to be a potentially safe treatment option.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/op-25-00131","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T19:59:37Z","timestamp":1758657577000},"page":"1040-1048","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Survival After Fertility-Sparing Surgery for Early-Stage Cervical Cancer Compared With Nonsparing Surgery: A Nationwide Comparative Study"],"prefix":"10.1200","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8427-7770","authenticated-orcid":true,"given":"Janneke T.","family":"Wolswinkel","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra L.M.","family":"Zusterzeel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anke","family":"Smits","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6085-0678","authenticated-orcid":true,"given":"Albert G.","family":"Siebers","sequence":"additional","affiliation":[{"name":"Palga, the Dutch Nationwide Pathology Databank, Houten, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans H.B.","family":"Wenzel","sequence":"additional","affiliation":[{"name":"Department of Research &amp; Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruud L.M.","family":"Bekkers","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the Netherlands"},{"name":"Department of Obstetrics and Gynaecology, Medical Centre and GROW School for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands"},{"name":"Department of Obstetrics and Gynaecology, Catharina Hospital, Eindhoven, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jogchum J.","family":"Beltman","sequence":"additional","affiliation":[{"name":"Department Obstetrics and Gynaecology, Leiden University Medical Centre, Leiden, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8693-7299","authenticated-orcid":true,"given":"Christianne A.R.","family":"Lok","sequence":"additional","affiliation":[{"name":"Centre for Gynaecological Oncology Amsterdam (CGOA), Antoni van Leeuwenhoek\/Netherlands Cancer Institute, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2838-2031","authenticated-orcid":true,"given":"Constantijne H.","family":"Mom","sequence":"additional","affiliation":[{"name":"Centre for Gynaecological Oncology Amsterdam (CGOA), Academic Medical Centre, Cancer Centre Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3656-947X","authenticated-orcid":true,"given":"Nienke E.","family":"van Trommel","sequence":"additional","affiliation":[{"name":"Centre for Gynaecological Oncology Amsterdam (CGOA), Antoni van Leeuwenhoek\/Netherlands Cancer Institute, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald P.","family":"Zweemer","sequence":"additional","affiliation":[{"name":"Department of Gynaecological Oncology, University Medical Centre Utrecht, Utrecht Cancer Centre, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jake S.F.","family":"Maurits","sequence":"additional","affiliation":[{"name":"Radboud University Medical Centre, IQ Health Science Department, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8846-0631","authenticated-orcid":true,"given":"Mieke L.G.","family":"Ten Eikelder","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_6_2_2","unstructured":"World Health Organization IAfRoCI: Global cancer observatory (GCO). 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