Obstetric outcomes of patients undergoing total laparoscopic radical trachelectomy for early stage cervical cancer

Gynecol Oncol. 2013 Oct;131(1):83-6. doi: 10.1016/j.ygyno.2013.07.108. Epub 2013 Aug 1.

Abstract

Objective: To assess the obstetric outcomes of our total laparoscopic radical trachelectomy (TLRT) cases for early stage cervical cancer.

Materials and methods: A total of 56 patients who underwent TLRT between December 2001 and August 2012 were reviewed retrospectively using clinicopathological, surgical, and follow-up data from patients' medical records.

Results: We performed this operation on 56 patients during the study period. The mean age of these 56 patients was 31.9 years (range 22-42 years). Fifty-three patients' fertility was preserved without requiring post-operative adjuvant treatment. Twenty-five women attempted to conceive, of whom 13 succeeded for a total of 21 pregnancies (52% pregnancy rate). Ten of these 21 pregnancies were the result of assisted reproductive technologies. Of those, 5 resulted in first trimester miscarriages, 2 in second trimester miscarriages, and 13 in live births. Ten pregnancies reached the third trimester. Preterm premature rupture of membranes (8/13, 61.5%) was the most common complication during pregnancy. The rate of preterm delivery was 47.6%. Three patients delivered at 22-28 weeks of gestational age. Two of these babies showed permanent damage: one has cerebral palsy; the other has developmental retardation. One pregnancy is ongoing.

Conclusion: TLRT is a useful technique associated with an excellent pregnancy rate in fertility-preserving surgery to treat early stage cervical cancer.

Keywords: Cervical cancer; Total laparoscopic radical trachelectomy.

MeSH terms

  • Abortion, Spontaneous / etiology
  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / surgery*
  • Adult
  • Carcinoma, Adenosquamous / drug therapy
  • Carcinoma, Adenosquamous / surgery*
  • Carcinoma, Squamous Cell / drug therapy
  • Carcinoma, Squamous Cell / surgery*
  • Chorioamnionitis / etiology
  • Female
  • Fertility Preservation*
  • Fetal Membranes, Premature Rupture / etiology
  • Humans
  • Infertility, Female / etiology
  • Laparoscopy
  • Live Birth
  • Pregnancy
  • Pregnancy Rate
  • Retrospective Studies
  • Uterine Cervical Neoplasms / drug therapy
  • Uterine Cervical Neoplasms / surgery*
  • Young Adult