Oncological and Reproductive Outcomes of Abdominal Radical Trachelectomy

Anticancer Res. 2020 Oct;40(10):5939-5947. doi: 10.21873/anticanres.14615.

Abstract

Background/Aim: There is an increasing demand for preserving the fertility of young women impacted with early-stage cervical cancer. The aim of this study is to evaluate the oncological and reproductive outcomes of abdominal radical trachelectomy (ART). Patients and Methods: We retrospectively reviewed patients with FIGO stageIA2-IB1 cervical cancer who underwent ART from 2007 to 2018. We also compared the oncological prognosis between the patients who underwent ART and radical hysterectomy (RH). Results: A total of 42 patients underwent ART. During median follow-up 62.5 months, there were 4 (9.5%) recurrences and 1 (2.4%) death. As for tumors ≤2 cm, the 5-year recurrence-free survival (RFS) rate and overall survival (OS) rate for patients who underwent ART was similar to those who underwent RH (89.8% vs. 92.7%, p=0.42 and 97.3% vs. 95.0%, p=0.44, respectively). Nineteen patients attempted to conceive and seven of them were successful. There was one case of a first-trimester miscarriage, two cases of preterm delivery, three cases of full-term delivery and one ongoing pregnancy. Conclusion: ART could be a feasible alternative to RH for patients with tumors ≤2 cm with comparable oncological outcome.

Keywords: Abdominal radical trachelectomy; cervical cancer; fertility preservation; fertility-sparing; radical hysterectomy.

MeSH terms

  • Abdomen / physiopathology
  • Abdomen / surgery*
  • Adult
  • Aged
  • Female
  • Fertility / physiology
  • Humans
  • Hysterectomy / adverse effects
  • Infant, Newborn
  • Middle Aged
  • Neoplasm Recurrence, Local / physiopathology
  • Neoplasm Recurrence, Local / surgery*
  • Neoplasm Staging
  • Pregnancy
  • Retrospective Studies
  • Trachelectomy / adverse effects*
  • Treatment Outcome
  • Uterine Cervical Neoplasms / physiopathology
  • Uterine Cervical Neoplasms / surgery*