Risks of Cervical Cancer Recurrence After Fertility-Sparing Surgery and the Role of Human Papillomavirus Infection Types
Aimagambetova G. Bapayeva G. Ukybassova T. Kamzayeva N. Sakhipova G. Shanazarov N. Terzic M.
November 2024Multidisciplinary Digital Publishing Institute (MDPI)
Journal of Clinical Medicine
2024#13Issue 21
Cervical cancer is a largely preventable malignancy of the uterine cervix. The tendencies in cervical cancer morbidity and mortality have remained similar for the past decade, albeit with increasing frequency in low- and middle-income countries (LMICs). Moreover, in the majority of LMICs, cervical cancer is the second most prevalent cancer and the second most common cause of cancer-related death among reproductive-age women. High-risk human papillomavirus (HR-HPV) infections have been proven to be associated with up to 95% of cervical cancer cases, with HPV-16 and HPV-18 types being responsible for approximately 70% of all cervical cancers, with the other high-risk HPV types accounting for up to a further 25%. More recently, the latest data appear to confirm there is a change in the frequency of HR-HPV occurrence, especially HPV-16 and HPV-18, as a reflection of the implementation of preventive vaccination programs. Owing to the growing incidence of cervical cancer among reproductive-age women and with the development of cancer management approaches, fertility-sparing options have been proposed for early-stage cervical cancer management as an option for young women, especially those with unaccomplished reproductive desires. However, methods applied for this purpose (cold-knife conization, loop electrosurgical excision, trachelectomy) have variable outcomes and do not prevent risks of relapse. Multiple factors are involved in cervical cancer recurrence, even in cases treated at the early stage of the disease. In this review, the authors unveil whether HPV infection and virus type could be one of the key factors associated with cervical cancer recurrence after fertility-sparing surgery. Reviews of the literature reveal that recurrent and persistent HR-HPV infection is a strong predictor of cervical lesions’ relapse. In particular, HPV-16 and HPV-18 infections and their persistence have been reported to be associated with cervical cancer recurrence. HR-HPV genotyping before and after fertility-sparing surgery for cervical cancer could facilitate a personalized approach and improve the overall survival rate. Screening for HR-HPV is essential during the follow-up of cervical cancer-treated women and will help to predict possible cancer recurrence.
cervical cancer , early-stage cervical cancer , fertility-sparing surgery , HPV type , HR-HPV , recurrence
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Department of Surgery, School of Medicine, Nazarbayev University, Astana, 010000, Kazakhstan
Clinical Academic Department of Women’s Health, CF “University Medical Center”, Astana, 010000, Kazakhstan
Department General Practitioners, West Kazakhstan Medical University, Aktobe, 030000, Kazakhstan
Center for Photodynamic Therapy, Medical Center Hospital of The President’s Affairs Administration of The Republic of Kazakhstan, Astana, 010000, Kazakhstan
Department of Surgery
Clinical Academic Department of Women’s Health
Department General Practitioners
Center for Photodynamic Therapy
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