针对宫颈癌患者的保留生育能力治疗 (FST) 旨在实现与根治性治疗后相当的肿瘤学结果，同时最大限度地提高生殖结果，包括受孕能力和最大限度地降低早产风险。国际多中心回顾性 FERTISS 研究重点关注接受过治疗的患者FST 分析了 FST 相对于妊娠的时间、受孕尝试和方法、流产率、降低严重早产风险的预防性程序、妊娠持续时间和分娩方式。在 13 个国家的 44 个中心接受治疗的 733 名患者中，49.7% 试图受孕在 72 个月的中位随访期间，22.6% (166/733) 的患者成功怀孕。与根治性宫颈切除术 (25.7%; 44/171, p < 0.001) 相比，非根治性手术 (63.2%; 122/193) 的成功率显着更高。现有围产学数据显示，89.5%（111/124）的患者自然怀孕。非根治性手术患者与根治性手术患者的首次妊娠流产率和分娩成功率没有显着差异。根治性手术后早产（妊娠 <38 周）的发生率高于非根治性手术（76.5% vs. 57.7%，p = 0.15）。几乎所有在妊娠期间接受常规超声宫颈测量并随后进行预防性手术的患者 (97.3%; 73/75) 均产下活胎，相比之下，未接受此类治疗的女性为 30.6% (15/49)，p < 0.001。根治性手术的妊娠率明显较高。大多数妊娠都会产生可存活的胎儿，但根治性宫颈切除术导致重度早产范围内的早产率较高。半数患者在 FST 后没有尝试怀孕。版权所有 © 2024 Elsevier Inc. 保留所有权利。

Fertility-sparing treatment (FST) for patients with cervical cancer intends to achieve oncologic outcomes comparable to those after radical treatment while maximizing reproductive outcomes, including the ability to conceive and minimizing the risk of prematurity.International multicentre retrospective FERTISS study focused on patients treated with FST analysed timing of FST relative to pregnancy, conception attempts and methods, abortion rates, prophylactic procedures reducing the risk of severe prematurity, pregnancy duration, and delivery mode.Of the 733 patients treated at 44 centres in 13 countries, 49.7% attempted to conceive during median follow-up of 72 months and 22.6% (166/733) patients achieved a successful pregnancy. Success rate was significantly higher after non-radical surgery (63.2%; 122/193) compared to radical trachelectomy (25.7%; 44/171, p < 0.001). Available perinatological data shows that 89.5% (111/124) of the patients became pregnant naturally. There was no significant difference in the abortion rate in the first pregnancy nor delivery success rates between non-radical and radical procedures patients. Preterm delivery (<38 weeks gestation) occurred more frequently after radical than non-radical procedures (76.5% vs. 57.7%, p = 0.15). Almost all patients (97.3%; 73/75) who underwent regular ultrasound cervicometry in pregnancy with subsequent prophylactic procedures delivered a live fetus, compared to 30.6% (15/49) women without such management, p < 0.001.Patients who underwent non-radical surgery had significantly higher pregnancy rates. Most pregnancies resulted in a viable fetus, but radical trachelectomy led to a higher rate of preterm births in the severe prematurity range. Half of the patients did not attempt pregnancy after FST.Copyright © 2024 Elsevier Inc. All rights reserved.