Conservative Management of Cervical Cancer with Rene Pareja

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Rene Pareja to discuss conservative management of cervical cancer. Dr. Pareja is a gynecologist-oncologist at Astorga Oncology Clinic in Medellín and the National Cancer Institute in Bogotá, Colombia. He is a reviewer for more than 20 specialty journals, an Associate Editor for IJGC, a member of the Editorial Board of Gynecology Oncology, and a member of the board of directors of the International Gynecological Cancer Society (IGCS). Additionally, he is a member of FIGO committee on Women's Cancer. Dr. Pareja is the author of nine book chapters and more than 70 publications in peer-reviewed journals, and at IGCS 2021 he received an award for Community Advancement in Resource-Limited Settings. Highlights: 1. Fertility preserving options have to be offered to all women wishing to preserve their fertility potential, that fulfil the ECOG status, histological, and imaging criteria. 2. It is recommended to have an evaluation by human reproduction specialized teams in order to rule out any potential impairment before the surgery. 3. The relapse rate for vaginal radical trachelectomy, abdominal radical trachelectomy and simple trachelectomy/conization are around 4-5%. 4. The highest live birth rates are seen in patients undergoing conization + lymph node assessment (over 88%).

5. Vaginal radical trachelectomy and minimally invasive radical trachelectomy, with preservation of ascendent branch of uterine artery, are contraindicated in women with tumors > 2 cm, due to the high rate of relapse (over 20%).