{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T05:17:22Z","timestamp":1769059042301,"version":"3.49.0"},"reference-count":89,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Fertility-sparing surgery (FSS) is a viable option for young women with early-stage cervical cancer (ECC); however, certain risk factors may necessitate additional treatments and impact fertility. This review examines the prevalence of these risk factors and available treatment options. Methods: A systematic search was conducted of studies including patients with ECC (IA1 with LVSI, IA2, IB1 (FIGO 2009)) who underwent FSS. Results: Sixty-four articles, comprising a total of 4118 women planned for FSS, were included. High- or intermediate-risk histologic features were found in 638 (15.5%) women: 5.1% had positive lymph node(s), 4.1% had positive resection margins, 0.3% had parametrial involvement, 1.0% had unspecified high-risk features, and 5.1% had intermediate-risk histology (primarily based on the Sedlis criteria). Adjuvant treatment impaired fertility in all women with adjuvant hysterectomy and\/or (chemo)radiation (58.7%). Adjuvant chemotherapy was given to 1351 (32.8%) patients, which may reduce fertility. Conclusions: Fertility preservation could be achieved in most women; but high- or intermediate-risk factors necessitate more extensive surgery or radiotherapy leading to infertility. Adjuvant chemotherapy could be an alternative treatment option considering its effectiveness, safety and higher change in fertility preservation. The low incidence of parametrial involvement justifies waiving parametrectomy in tumors &lt; 2 cm.<\/jats:p>","DOI":"10.3390\/cancers15153920","type":"journal-article","created":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T09:32:35Z","timestamp":1690882355000},"page":"3920","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["High- or Intermediate-Risk Histologic Features in Patients with Clinical Early-Stage Cervical Cancer Planned for Fertility-Sparing Surgery: A Systematic Review"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8427-7770","authenticated-orcid":false,"given":"Janneke T.","family":"Wolswinkel","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mieke L. G. ten","family":"Eikelder","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cornelia G.","family":"Verhoef","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petra L. M.","family":"Zusterzeel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,1]]},"reference":[{"key":"ref_1","unstructured":"Global Cancer Observatory (GCO) (2023, May 20). World Health Organization, International Agency for Research on Cancer (IARC). Available online: https:\/\/gco.iarc.fr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.ygyno.2018.04.571","article-title":"Less versus more radical surgery in stage IB1 cervical cancer: A population-based study of long-term survival","volume":"150","author":"Tseng","year":"2018","journal-title":"Gynecol. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1097\/IGC.0000000000001216","article-title":"The European Society of Gynaecological Oncology\/European Society for Radiotherapy and Oncology\/European Society of Pathology Guidelines for the Management of Patients With Cervical Cancer","volume":"28","author":"Cibula","year":"2018","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"64","DOI":"10.6004\/jnccn.2019.0001","article-title":"Cervical Cancer, Version 2.2019, NCCN Clinciala Practice Guidelines in Oncology","volume":"17","author":"Koh","year":"2019","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.ygyno.2022.01.023","article-title":"Oncologic results of fertility sparing surgery of cervical cancer: An updated systematic review","volume":"165","author":"Morice","year":"2022","journal-title":"Gynecol. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1200\/JCO.2000.18.8.1606","article-title":"Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix","volume":"18","author":"Peters","year":"2000","journal-title":"J. Clin. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Guimar\u00e3es, Y.M., Godoy, L.R., Longatto-Filho, A., and Reis, R.D. (2022). Management of Early-Stage Cervical Cancer: A Literature Review. Cancers, 14.","DOI":"10.3390\/cancers14030575"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1006\/gyno.1999.5387","article-title":"A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage IB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: A Gynecologic Oncology Group Study","volume":"73","author":"Sedlis","year":"1999","journal-title":"Gynecol. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1016\/j.ygyno.2021.06.017","article-title":"Beyond Sedlis-A novel histology-specific nomogram for predicting cervical cancer recurrence risk: An NRG\/GOG ancillary analysis","volume":"162","author":"Levinson","year":"2021","journal-title":"Gynecol. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Park, B.K., and Kim, T.-J. (2021). Useful MRI Findings for Minimally Invasive Surgery for Early Cervical Cancer. Cancers, 13.","DOI":"10.3390\/cancers13164078"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.ejca.2020.06.034","article-title":"Sentinel lymph node mapping and intraoperative assessment in a prospective, international, multicentre, observational trial of patients with cervical cancer: The SENTIX trial","volume":"137","author":"Cibula","year":"2020","journal-title":"Eur. J. Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1089\/gyn.2021.0048","article-title":"Fertility-Sparing Options Versus Abdominal Radical Hysterectomy for Patients with Early Cervical Cancer: Belarus\u2019 10-Year Experience","volume":"37","author":"Matylevich","year":"2021","journal-title":"J. Gynecol. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/j.ygyno.2010.12.345","article-title":"The vaginal radical trachelectomy: An update of a series of 125 cases and 106 pregnancies","volume":"121","author":"Plante","year":"2011","journal-title":"Gynecol. Oncol."},{"key":"ref_15","unstructured":"Higgins, J., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M., and Welch, V. (2022). Cochrane Handbook for Systematic Reviews of Interventions Version 6.3, Cochrane."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1080\/01443615.2018.1498830","article-title":"Oncological and obstetric outcomes after fertility-sparing radical abdominal trachelectomy for early stage cervical cancer: A tertiary centre\u2019s 10 years\u2019 experience","volume":"39","author":"Ayhan","year":"2019","journal-title":"J. Obstet. Gynaecol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1007\/s12262-015-1351-3","article-title":"Radical Vaginal Trachelectomy with Laparoscopic Pelvic Lymphadenectomy for Fertility Preservation in Young Women with Early-Stage Cervical Cancer","volume":"78","author":"Bratila","year":"2016","journal-title":"Indian J. Surg."},{"key":"ref_18","first-page":"62","article-title":"Fertility preservation in cervical cancer, analysis of 30 years of practice and immersion in future developments","volume":"50","author":"Zaccarini","year":"2022","journal-title":"Gynecol. Obstet. Fertil. Senol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/S0090-8258(02)00142-7","article-title":"Radical vaginal trachelectomy and pelvic lymphadenectomy for preservation of fertility in early cervical carcinoma","volume":"88","author":"Burnett","year":"2003","journal-title":"Gynecol. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.ejogrb.2006.10.014","article-title":"A fertility-preserving option in early cervical carcinoma: Laparoscopy-assisted vaginal radical trachelectomy and pelvic lymphadenectomy","volume":"136","author":"Chen","year":"2008","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_21","first-page":"S201","article-title":"Robotic-assisted radical trachelectomy","volume":"1","author":"Choi","year":"2009","journal-title":"Gynecol. Surg."},{"key":"ref_22","first-page":"314","article-title":"Laparoscopic radical trachelectomy with pelvic lymphadenectomy-case series of 17 patients from a brazilian cancer center","volume":"26","author":"Cintra","year":"2016","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.ygyno.2016.04.207","article-title":"Fertility preservation and pregnancy outcomes in women with cervical cancer following robotic radical trachelectomy","volume":"1","author":"Clark","year":"2016","journal-title":"Gynecol. Oncol."},{"key":"ref_24","first-page":"613","article-title":"Surgical and pathological outcomes of radical abdominal trachelectomy versus hysterectomy for stage ib1 cervical cancer","volume":"4","author":"Dandan","year":"2014","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"475","DOI":"10.5603\/GP.a2018.0081","article-title":"Simple vaginal trachelectomy for early stage cervical cancer: A tertiary cancer center experience","volume":"89","author":"Demirkiran","year":"2018","journal-title":"Ginekol. Pol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"3422","DOI":"10.18632\/oncotarget.13788","article-title":"Abdominal radical trachelectomy guided by sentinel lymph node biopsy for stage IB1 cervical cancer with tumors >2 cm","volume":"8","author":"Deng","year":"2017","journal-title":"Oncotarget"},{"key":"ref_27","first-page":"A39","article-title":"Fertility-sparing radical trachelectomy for early stage cervical cancer: 12 cases series and literature review","volume":"31","author":"Doan","year":"2021","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.ygyno.2021.12.029","article-title":"Long term oncologic and reproductive outcomes after robot-assisted radical trachelectomy for early-stage cervical cancer. An international multicenter study","volume":"164","author":"Ekdahl","year":"2022","journal-title":"Gynecol. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1016\/j.fertnstert.2010.11.010","article-title":"Excisional cone as fertility-sparing treatment in early-stage cervical cancer","volume":"95","author":"Fagotti","year":"2011","journal-title":"Fertil. Steril."},{"key":"ref_30","first-page":"E190","article-title":"Retrospective analysis of abdominal radical trachelectomy in our 140 cases","volume":"3","author":"Fujii","year":"2012","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1097\/IGC.0000000000000114","article-title":"Nerve-Sparing Radical Abdominal Trachelectomy Versus Nerve-Sparing Radical Hysterectomy in Early-Stage (FIGO IA2-IB) Cervical Cancer A Comparative Study on Feasibility and Outcome","volume":"24","author":"Gaarenstroom","year":"2014","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Gil-Ibanez, B., Gil-Moreno, A., Torne, A., Jimenez, A.M., Gorostidi, M., Zapardiel, I., Garcia, A.T., Diaz-Feijoo, B., and Task, S.S.-G.C.C. (2022). Tumor Size and Oncological Outcomes in Patients with Early Cervical Cancer Treated by Fertility Preservation Surgery: A Multicenter Retrospective Cohort Study. Cancers, 14.","DOI":"10.3390\/cancers14092108"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.ejogrb.2020.05.039","article-title":"Vaginal fertility-sparing surgery and laparoscopic sentinel lymph node detection in early cervical cancer. Retrospective study with 15 years of follow-up","volume":"251","author":"Glickman","year":"2020","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/j.jmig.2018.06.006","article-title":"Surgical and Oncologic Outcomes of Radical Abdominal Trachelectomy Versus Hysterectomy for Stage IA2-IB1 Cervical Cancer","volume":"26","author":"Guo","year":"2019","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/j.ygyno.2015.05.016","article-title":"Vaginal Radical Trachelectomy for early stage cervical cancer. Results of the Danish National Single Center Strategy","volume":"138","author":"Hauerberg","year":"2015","journal-title":"Gynecol. Oncol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.ygyno.2011.06.024","article-title":"Early adenocarcinoma of the cervix: Is radical vaginal trachelectomy safe?","volume":"123","author":"Helpman","year":"2011","journal-title":"Gynecol. Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.ygyno.2021.07.031","article-title":"Twenty years of experience with less radical fertility-sparing surgery in early-stage cervical cancer: Oncological outcomes","volume":"163","author":"Hruda","year":"2021","journal-title":"Gynecol. Oncol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.ygyno.2008.12.025","article-title":"Intraoperative margin assessment of the radical trachelectomy specimen","volume":"113","author":"Ismiil","year":"2009","journal-title":"Gynecol. Oncol."},{"key":"ref_39","first-page":"309","article-title":"Radical abdominal trachelectomy in managing early cervical invasion","volume":"30","author":"Jeremic","year":"2009","journal-title":"Eur. J. Gynaecol. Oncol."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Kanao, H., Aoki, Y., Fusegi, A., Omi, M., Nomura, H., Tanigawa, T., Okamoto, S., Kurita, T., Netsu, S., and Omatsu, K. (2021). Feasibility and Outcomes of \u201cNo-Look No-Touch\u201d Laparoscopic Radical Trachelectomy for Early-Stage Cervical Cancer. J. Clin. Med., 10.","DOI":"10.3390\/jcm10184154"},{"key":"ref_41","first-page":"871","article-title":"Oncological and fertility outcomes following simple vaginal trachelectomy for early stage cervical cancer","volume":"4","author":"Kathurusinghe","year":"2014","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1111\/jog.12980","article-title":"Possibility of less radical treatment for patients with early invasive uterine cervical cancer","volume":"42","author":"Kim","year":"2016","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"688","DOI":"10.31083\/j.ejgo4204105","article-title":"Reproductive outcomes after radical abdominal trachelectomy for cervical cancer","volume":"42","author":"Konishi","year":"2021","journal-title":"Eur. J. Gynaecol. Oncol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1097\/IGC.0000000000000031","article-title":"Laparoscopic Radical Trachelectomy Is an Alternative to Laparotomy With Improved Perioperative Outcomes in Patients With Early-Stage Cervical Cancer","volume":"24","author":"Kucukmetin","year":"2014","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.1097\/IGC.0b013e3182216aa7","article-title":"Radical Vaginal Trachelectomy (RVT) Combined With Laparoscopic Lymphadenectomy Prospective Study of 225 Patients With Early-Stage Cervical Cancer","volume":"21","author":"Lanowska","year":"2011","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1111\/1471-0528.15621","article-title":"Oncological results and recurrent risk factors following abdominal radical trachelectomy: An updated series of 333 patients","volume":"126","author":"Li","year":"2019","journal-title":"BJOG"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1097\/IGC.0000000000000023","article-title":"Fertility Conserving Management of Early Cervical Cancer Our Experience of LLETZ and Pelvic Lymph Node Dissection","volume":"24","author":"Lindsay","year":"2014","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.ygyno.2013.04.470","article-title":"Total laparoscopic radical trachelectomy in the treatment of early squamous cell cervical cancer: A retrospective study with 8-year follow-up","volume":"130","author":"Lu","year":"2013","journal-title":"Gynecol. Oncol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.ejogrb.2021.09.017","article-title":"Conization and lymph node evaluation in low-risk cervical cancer. Is it time to avoid radical surgery? Retrospective series and literature review","volume":"266","author":"Lucchini","year":"2021","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1007\/s00404-018-4972-5","article-title":"Long-term fertility, oncological, and quality-of-life outcomes after trachelectomy in early stage cervical cancer","volume":"299","author":"Malmsten","year":"2019","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.ygyno.2007.03.009","article-title":"Oncological safety of laparoscopic-assisted vaginal radical trachelectomy (LARVT or Dargent\u2019s operation): A comparative study with laparoscopic-assisted vaginal radical hysterectomy (LARVH)","volume":"106","author":"Marchiole","year":"2007","journal-title":"Gynecol. Oncol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1136\/ijgc-2020-001740","article-title":"Conization and lymph node evaluation as a fertility-sparing treatment for early stage cervical cancer","volume":"31","author":"Martinelli","year":"2021","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_53","first-page":"S196","article-title":"Russian experience in abdominal radical trachelectomy","volume":"1","author":"Novikova","year":"2009","journal-title":"Gynecol. Surg."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1007\/s10147-020-01778-8","article-title":"Evaluation of adjuvant chemotherapy after abdominal trachelectomy for cervical cancer: A single-institution experience","volume":"26","author":"Okugawa","year":"2021","journal-title":"Int. J. Clin. Oncol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.ygyno.2008.07.019","article-title":"Abdominal radical trachelectomy for invasive cervical cancer: A case series and literature review","volume":"111","author":"Pareja","year":"2008","journal-title":"Gynecol. Oncol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1002\/jso.23631","article-title":"Long-Term Outcomes After Fertility-Sparing Laparoscopic Radical Trachelectomy in Young Women With Early-Stage Cervical Cancer: An Asan Gynecologic Cancer Group (AGCG) Study","volume":"110","author":"Park","year":"2014","journal-title":"J. Surg. Oncol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/j.ygyno.2012.08.022","article-title":"Reproducibility and accuracy of robot-assisted laparoscopic fertility sparing radical trachelectomy","volume":"127","author":"Persson","year":"2012","journal-title":"Gynecol. Oncol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1097\/IGC.0000000000000989","article-title":"Simple Vaginal Trachelectomy A Valuable Fertility-Preserving Option in Early-Stage Cervical Cancer","volume":"27","author":"Plante","year":"2017","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"A56","DOI":"10.1136\/ijgc-2020-001432","article-title":"Simple vaginal trachelectomy in women with early-stage low risk cervical cancer who wish to preserve fertility: The new standard of care ?","volume":"30","author":"Plante","year":"2020","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1097\/IGC.0000000000001048","article-title":"Intention-to-Treat Analysis of Radical Trachelectomy for Early-Stage Cervical Cancer With Special Reference to Oncologic Failures: Single-Institutional Experience in Hungary","volume":"27","author":"Poka","year":"2017","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1097\/IGC.0b013e3182370f51","article-title":"Fertility-Sparing Surgery for Early Cervical Cancer-Approach to Less Radical Surgery","volume":"22","author":"Raju","year":"2012","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_62","first-page":"735","article-title":"Evaluation of pathologic features in trachelectomy specimens and correlation with outcomes-a single institution experience","volume":"101","author":"Ramalingam","year":"2021","journal-title":"Lab. Investig."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.gore.2019.03.005","article-title":"Less radical surgery for women with early stage cervical cancer: Our experience on radical vaginal trachelectomy and laparoscopic pelvic lymphadenectomy","volume":"28","author":"Rizzuto","year":"2019","journal-title":"Gynecol. Oncol. Rep."},{"key":"ref_64","first-page":"231","article-title":"Abdominal radical trachelectomy in cervical cancers > 2 cm","volume":"1","author":"Saso","year":"2013","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1067\/mob.2003.124","article-title":"Radical trachelectomy and pelvic lymphadenectomy with uterine preservation in the treatment of cervical cancer","volume":"188","author":"Schlaerth","year":"2003","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1111\/j.1471-0528.2006.00936.x","article-title":"Radical vaginal trachelectomy as a fertility-sparing procedure in women with early-stage cervical cancer\u2014Cumulative pregnancy rate in a series of 123 women","volume":"113","author":"Shepherd","year":"2006","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_67","first-page":"S39","article-title":"Oncologic outcomes of patients who received adjuvant chemoradiation after radical trachelectomy","volume":"1","author":"Sonoda","year":"2010","journal-title":"Gynecol. Oncol."},{"key":"ref_68","first-page":"E765","article-title":"Radical abdominal tracelectomy in treatment of invasive cervical cancer patients","volume":"3","author":"Svintsitsky","year":"2012","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1097\/LGT.0b013e31827cce89","article-title":"Abdominal Radical Trachelectomy: A Safe and Feasible Option for Fertility Preservation in Developing Countries","volume":"17","author":"Testa","year":"2013","journal-title":"J. Low. Genit. Tract. Dis."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1097\/IGC.0000000000000991","article-title":"Conization in Early Stage Cervical Cancer Pattern of Recurrence in a 10-Year Single-Institution Experience","volume":"27","author":"Tomao","year":"2017","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_71","first-page":"419","article-title":"Outcomes of fertility preserving surgery with trachelectomy for early stage cervical cancer at a major UK cancer centre","volume":"28","author":"Tsang","year":"2018","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1111\/j.1471-0528.2004.00421.x","article-title":"Abdominal radical trachelectomy: A fertility-preserving option for women with early cervical cancer","volume":"112","author":"Ungar","year":"2005","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/j.ygyno.2015.06.023","article-title":"Radical trachelectomy in early-stage cervical cancer: A comparison of laparotomy and minimally invasive surgery","volume":"138","author":"Vieira","year":"2015","journal-title":"Gynecol. Oncol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"2881","DOI":"10.1177\/0300060519845974","article-title":"Multicenter research on tumor and pregnancy outcomes in patients with early-stage cervical cancer after fertility-sparing surgery","volume":"47","author":"Wang","year":"2019","journal-title":"J. Int. Med. Res."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.tjog.2016.05.014","article-title":"Radical trachelectomy for early stage cervical cancer: A case series and literature review","volume":"56","author":"Wu","year":"2017","journal-title":"Taiwan. J. Obstet. Gynecol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"373","DOI":"10.5468\/ogs.2016.59.5.373","article-title":"Surgical and obstetrical outcomes after laparoscopic radical trachelectomy and pelvic lymphadenectomy for early cervical cancer","volume":"59","author":"Yoo","year":"2016","journal-title":"Obstet. Gynecol. Sci."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1097\/IGC.0000000000000763","article-title":"Vaginal Radical Trachelectomy for Early-Stage Cervical Cancer: Increased Recurrence Risk for Adenocarcinoma","volume":"26","author":"Zusterzeel","year":"2016","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"5560","DOI":"10.1007\/s00330-020-06909-3","article-title":"Diagnostic performance of conventional and advanced imaging modalities for assessing newly diagnosed cervical cancer: Systematic review and meta-analysis","volume":"30","author":"Woo","year":"2020","journal-title":"Eur. Radiol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.ejca.2020.10.037","article-title":"Completion of radical hysterectomy does not improve survival of patients with cervical cancer and intraoperatively detected lymph node involvement: ABRAX international retrospective cohort study","volume":"143","author":"Cibula","year":"2021","journal-title":"Eur. J. Cancer"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1002\/ijgo.12749","article-title":"Revised FIGO staging for carcinoma of the cervix uteri","volume":"145","author":"Bhatla","year":"2019","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"ref_81","unstructured":"American Association for Cancer Research (2023). Simple Hysterectomy Safe for Some Cervical Cancers. Cancer Discov."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Bogani, G., Di Donato, V., Scambia, G., Raspagliesi, F., Chiantera, V., Sozzi, G., Golia D\u2019Aug\u00e8, T., Muzii, L., Benedetti Panici, P., and D\u2019Oria, O. (2022). Radical Hysterectomy for Early Stage Cervical Cancer. Int. J. Environ. Res. Public. Health, 19.","DOI":"10.3390\/ijerph191811641"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1136\/ijgc-2019-000558","article-title":"Robot-assisted approach to cervical cancer (RACC): An international multi-center, open-label randomized controlled trial","volume":"29","author":"Falconer","year":"2019","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_84","first-page":"Cd007583","article-title":"Radiotherapy and chemoradiation after surgery for early cervical cancer","volume":"5","author":"Rogers","year":"2012","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1025018","DOI":"10.3389\/fendo.2022.1025018","article-title":"The effects and mechanism of taxanes on chemotherapy-associated ovarian damage: A review of current evidence","volume":"13","author":"Wu","year":"2022","journal-title":"Front. Endocrinol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"2500","DOI":"10.1200\/JCO.2013.49.2678","article-title":"Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update","volume":"31","author":"Loren","year":"2013","journal-title":"J. Clin. Oncol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1002\/ijc.30793","article-title":"Comparison of adjuvant therapy for node-positive clinical stage IB-IIB cervical cancer: Systemic chemotherapy versus pelvic irradiation","volume":"141","author":"Matsuo","year":"2017","journal-title":"Int. J. Cancer"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1016\/j.ygyno.2019.09.012","article-title":"Fertility preservation in gynecologic cancers","volume":"155","author":"Taylan","year":"2019","journal-title":"Gynecol. Oncol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"443.e1","DOI":"10.1016\/j.ajog.2022.11.1295","article-title":"Analysis of risk factors for recurrence in cervical cancer patients after fertility-sparing treatment: The FERTIlity Sparing Surgery retrospective multicenter study","volume":"228","author":"Slama","year":"2023","journal-title":"Am. J. Obstet. 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