Abdominal radical trachelectomy as a fertility-sparing procedure in women with early-stage cervical cancer in a series of 61 women

Gynecol Oncol. 2009 Oct;115(1):51-55. doi: 10.1016/j.ygyno.2009.06.036. Epub 2009 Jul 30.

Abstract

Objective: This retrospective study was conducted as a review of a series of women who had undergone abdominal radical trachelectomy and pelvic lymphadenectomy for early-stage cervical cancer.

Methods: We performed a retrospective review of patients who had undergone an abdominal radical trachelectomy. Data regarding tumor size and histology, surgical complications, recurrences, pregnancies and live births were collected and were presented as a percentage of the total number of cases.

Results: A total of 61 women were followed up for a median of 27 months (range: one month--79 months). There were six recurrences (9.8%); none of the recurrences occurred in patients with a tumor diameter of <20 mm except in one case with adenocarcinoma. Twenty-nine women attempted to conceive; four of these women were successful. All four of these women had live births: two had preterm deliveries, and the remaining two had full-term deliveries. The cumulative pregnancy rate among the women who attempted to conceive was 13.8% (4/29).

Conclusion: Among selected women with early-stage cervical cancer, especially those with a tumor diameter of <20 mm, abdominal radical trachelectomy and pelvic lymphadenectomy is a fertility-sparing treatment option, even though the cumulative conception rate was not particularly high compared with that for women who had undergone a vaginal radical trachelectomy.

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery
  • Adult
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery
  • Disease-Free Survival
  • Female
  • Fertility*
  • Gynecologic Surgical Procedures / methods
  • Humans
  • Neoplasm Staging
  • Pregnancy
  • Pregnancy Rate
  • Treatment Outcome
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / surgery*