Dear Colleagues,

The need to provide curative but less-morbid therapeutic options for women affected by gynecological cancers has been appreciated in recent years, with a relevant increase in the number of studies focused on the potential benefits and risks of minimally invasive fertility-sparing surgical procedures.

The objective of fertility-sparing treatment in patients affected by gynecological cancers is to guarantee adequate reproductive function while maintaining a low risk of long-term disease recurrence. The management of patients wishing to maintain fertility is complex and requires adequate counselling from a multidisciplinary team; working closely and engaging in discussion with fertility specialists is a prerequisite if women are to be given the best chance of obtaining a successful future pregnancy.

Currently, there are several key factors influencing the recommendation for fertility-sparing surgery, and the preoperative planning of these surgical procedures should be based on the optimal selection of patients with an accurate preoperative examination. Oncologic and obstetric outcomes related to the specific type of surgical approach and the necessity of adjuvant medical options should be assessed.

There are several approaches for fertility preservation in cervical cancer, such as cervical conization or radical trachelectomy. Uterine-sparing options such as hormonal therapy (in primis progestins) may be considered for women with early-stage, low-grade endometrial cancer. Ovarian borderline tumors tend to be diagnosed more commonly in younger women, and for this reason can often be treated with conservative surgery. Fertility-sparing surgery in combination with comprehensive surgical staging may be performed in selected young patients with invasive ovarian cancer and apparent disease confined to one ovary.

This Special Issue shall welcome contributions of original articles as well as narrative and systematic reviews, with or without meta-analysis. Overall, this Issue aims to provide summaries of the current evidence, in addition to new developing discoveries and future directions in the field of the minimally invasive and fertility-sparing treatment of gynecological cancers.

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• Fertility-sparing surgery
• Endometrial cancer
• Cervical cancer
• Ovarian cancer
• Conization
• Trachelectomy
• Sentinel lymph node
• Progestins
• Oophorectomy