Fertility-Sparing Surgery Doesn’t Compromise Survival in Early Cervical Cancer, Major Study Finds
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A new study published October 14, 2025, offers encouraging news for young women diagnosed with early-stage cervical cancer who wish to preserve their fertility. Researchers found that fertility-sparing surgery (FSS) does not negatively impact overall survival rates compared to radical hysterectomy,despite a slightly increased risk of cancer recurrence.
The large-scale, nationwide study-one of the most complete of its kind-addresses a critical concern for patients seeking to balance cancer treatment with their reproductive goals. The findings provide valuable data to inform shared decision-making between doctors and patients.
Study Details & Methodology
The retrospective matched cohort study,appearing in JCO Oncology Practice,analyzed data from 1,446 patients between the ages of 18 and 45 diagnosed with Federation Internationale de Gynecologie et d’Obstetrique (FIGO) 2018 stage IA1 to IB2 cervical cancer in the Netherlands between 2000 and 2022. Patients were carefully matched in groups of one undergoing FSS to two undergoing radical hysterectomy, based on cancer stage, histology, and the presence of lymph vascular space invasion.
The FSS procedures included cone biopsy, large loop excision of the transformation zone, or trachelectomy. the primary outcomes measured were recurrence-free survival and overall survival.
Researchers noted that patients choosing FSS tended to be younger-with a median age of 30 years compared to 39 years in the hysterectomy group-and were diagnosed more recently.Additionally, the FSS group presented with slightly smaller tumors and fewer instances of cancer spread to lymph nodes.
Recurrence Risk & Long-Term Outcomes
After a median follow-up period of 8.9 years (ranging from 4.4 to 13.7 years), recurrence occurred in 4.8% of all participants. However, the rate was higher in the FSS group (7.1%) compared to the hysterectomy group (3.6%), resulting in a hazard ratio (HR) of 2.21 (95% confidence interval (CI): 1.38-3.56).
This difference in recurrence rates was notably pronounced among women with FIGO stage IB1 disease, where the hazard ratio climbed to 4.76 (95% CI: 1.92-11.83). Despite this elevated risk of recurrence, overall survival rates remained comparable between the two groups-96.6% for FSS and 97.4% for hysterectomy (HR = 1.06, 95% CI = 0.62-1.80).
“Our results emphasize that FSS is a potentially safe option for women with early-stage cervical cancer and the desire to have children,” stated a lead researcher involved in the study.
Implications for Patient Care
The study’s lead author,Janneke T. Wolswinkel, MD, of the Department of Obstetrics and Gynaecology at Radboud university Medical Centre in Nijmegen, the Netherlands, emphasized the importance of these findings for patient counseling. The research suggests that FSS can be a viable option for appropriately selected patients, allowing them to potentially preserve their fertility without compromising their long-term survival.
For complete disclosure facts regarding all study authors, please visit ascopubs.org. this research offers a notable step forward in personalized cancer care, empowering women with early-stage cervical cancer to make informed decisions aligned with their individual values and reproductive goals.
