Keywords
cervical cancer
ovarian cancer
endometrial cancer
smooth muscle tumors of the uterine corpus of uncertain malignant potential (STUMP)
How to Cite
Abstract
Introduction. Currently, there is no standardized concept of fertility‑sparing treatment for women of reproductive age in gynecologic oncology. Researchers worldwide are accumulating experience, refining patient selection criteria, and optimizing surgical approaches to develop personalized management and follow‑up algorithms.
Aim. To evaluate reproductive outcomes and survival in reproductive-age patients after fertility-sparing treatment for malignant neoplasms of the female reproductive system.
Materials and Methods. A retrospective, single-center study including 420 reproductive-age patients (aged 18 to 45 years) with gynecologic malignancies. All patients underwent diagnosis, examination, and fertility-sparing surgery at the Department of Innovative Oncology and Gynecology at the V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology between January 2019 and January 2025. At the time of diagnosis, a full examination and surgical treatment were performed in accordance with the standards and guidelines adopted in the Russian Federation.
Results. Of the 420 patients, 273 (65.0%) completed fertility-sparing treatment. Recurrences were observed in 2 (2.6%) patients with cervical cancer, 20 (33.3%) with borderline ovarian tumors, 5 (16.1%) with early‑stage ovarian cancer, and 22 (21.1%) with endometrial cancer. No recurrences were recorded in patients with smooth muscle tumors of the uterus of uncertain malignant potential (STUMP). Two patients died after fertility-sparing treatment for cervical cancer. Pregnancy was achieved in 13 (16.7%) patients with cervical cancer, 22 (36.7%) with borderline ovarian tumors, 4 (12.5%) with ovarian cancer, 63 (66.3%) with early‑stage endometrial cancer, and 1 (10.0%) with STUMP.
Conclusion. The results, combined with global literature data, confirm the feasibility of fertility-sparing surgery in gynecologic oncology, demonstrating high oncological safety and favorable reproductive outcomes. An individualized approach to fertility-sparing treatment enables not only good survival rates but also, in many cases, the preservation of fertility in young patients.
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Copyright (c) 2026 Валентина Владимировна Литвинова, Дмитрий Леонидович Оводенко, Арина Олеговна Двойнишникова, Залина Руслановна Шебзухова, Майя Викторовна Санникова, Полина Леонидовна Шешко, Станислав Михайлович Пронин, Элеонора Валерьевна Кирилова, Альмина Михайловна Бирюкова, Татьяна Алексеевна Назаренко, Лев Андреевич Ашрафян