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585 Glassy cell cervical cancer: a retrospective study with a focus on fertility sparing approach
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585 Glassy cell cervical cancer: a retrospective study with a focus on fertility sparing approach
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585 Glassy cell cervical cancer: a retrospective study with a focus on fertility sparing approach
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Journal Article
585 Glassy cell cervical cancer: a retrospective study with a focus on fertility sparing approach
2024
Overview
Introduction/BackgroundCervical cancer is the fourth most common cancer in women worldwide and almost 50% of cases are diagnosed in women younger than 35 years old. According to international guidelines, fertility sparing treatment in young patients is evaluated in early-stage disease with tumors <4 cm, negative nodes and non-aggressive histological subtype. Glassy cell cervical carcinoma (GCCC) is an extremely rare poorly differentiated carcinoma, characterized by aggressive behavior and poor prognosis and with no indication of fertility sparing approach. We reported our experience with GCCC with focus on conservative treatment.MethodologyWe collected clinical data, survival analysis, relapse rates of patients with diagnosis of GCCC from two institutes between 2000 and 2021.ResultsA total of twentyone cases were identified and collected, regardless of the stage. Median age was 48 years old (range 29–67). According to the 2009 FIGO staging system most patients had a stage IIB (8, 38%). Radical hysterectomy was performed in 12 cases (57%) and adjuvant treatment was proposed based on pathological risk factors. Nine patients (43%) underwent neoadjuvant treatment. Relapse was reported in six (28%) patients with a median time of 6 months (range 1–21) and 62% (13) died of disease. After counseling two nulliparous young patients with FIGO stage Ib1 opted for fertility sparing approach. Both of them had pregnancy during follow-up time. One patient performed cerclage due to cervical insufficiency at 13 weeks and had a vaginal delivery at 37 weeks. The other one decided for a cesarean section after 37 weeks. Obstetrics outcome was excellent. Currently, the patients have no evidence of disease.ConclusionGCCC is a very aggressive histological subtype with poor outcome. Radical hysterectomy is the standard of care in an early stage due at the unfavorable prognosis. For our experience fertility sparing surgery may be considered as an option for well selected patients.DisclosuresNothing to declare.
Publisher
BMJ Publishing Group Ltd,Elsevier Inc,Elsevier Limited
Subject
