The Safety And Efficacy Of Fertility Preservation In Patients With Early-stage Cervical Cancer: A Meta-Analysis

Objective: Cervical cancer is one of the common gynecological malignant tumors in women.The incidence trend is getting younger and younger,and the desire for patients to retain fertility is becoming more and more intense.the purpose of this study was to assess the effectiveness and safety of cervical cancer patients who retain fertility.Methods: The datebases including PubMed,EMBASE,Web of Science,The Cochrane Library,CNKI,WanFang Date,CBM.Searching the literatures of fertility-sparing in young women with cervical cancer patients,manual search of domestic and foreign journals and journals,access to relevant literature,search time from inception to November 3,2018,two review authors independently read,screen,extract data and quality evaluation.Analysis was performed using RevMan 5.3software.Results: This article included 18 studies and meta-analysis,The results suggest that,for RT and RH,there was significant difference in postoperative transfusion rates[OR=0.35,95% CI: 0.16-0.78,P=0.01)],the incidence of postoperative infection complications [OR=0.45,95% CI: 0.21-0.94,P=0.03],postoperative adjuvant chemotherapy [OR=0.76,95% CI: 0.58-0.99,P=0.04],postoperative adjuvant radiotherapy [OR=0.55,95% CI: 0.41-0.74,P=0.00001],there was no significant difference in the recurrence rate after surgery [OR=1.04,95% CI :0.62-1.73,P=0.90],mortality [OR=1.08,95% CI: 0.76-1.55,P=0.66],5-year disease-free survival rate[OR=1.13,95% CI: 0.69-1.87,P=0.62],5-year overall survival rate [OR=0.98,95%CI: 0.71-1.37,P=0.93],intraoperative ureteral injury rate [OR=0.74,95% CI:0.18-3.12,P=0.69],the incidence of intraoperative vascular injury [OR=1.65,95% CI:0.48-5.62,P=0.43],the incidence of postoperative lymphocystosis [OR=0.89,95% CI:0.54-1.47,P = 0.64],the incidence of postoperative bladder dysfunction [OR = 0.86,95% CI: 0.52-1.43,P = 0.57].Conclusion: It is safe and feasible to preserve fertility in patients with cervical cancer.There is no difference in postoperative complications,and there is no significant difference in tumor outcome.