Radical vaginal trachelectomy as a fertility‐sparing procedure in women with early‐stage cervical cancer—cumulative pregnancy rate in a series of 123 women
- 2 May 2006
- journal article
- Published by Wiley in BJOG: An International Journal of Obstetrics and Gynaecology
- Vol. 113 (6), 719-724
- https://doi.org/10.1111/j.1471-0528.2006.00936.x
Abstract
Objective To analyse the fertility rates, complications and recurrences in a group of women who have undergone radical vaginal trachelectomy and pelvic lymphadenectomy for early-stage cervical cancer. Design An observational series. Setting A Gynaecological Oncology Centre. Population One hundred and twenty-three consecutive women who underwent radical vaginal trachelectomy and pelvic lymphadenectomy for early-stage cervical cancer. Methods Data were collected prospectively. Main outcome measures Complications, recurrences, pregnancies and live births are presented as percentages of the total population. Fertility is presented as a 5-year cumulative rate, with women attempting to conceive as the denominator. Results A total of 123 women were followed up for an average of 45 months. Eleven (8.9%) had completion treatment (two radical hysterectomies and nine chemoradiotherapy) at the time of initial treatment. There were three recurrences (2.7%) among the women who did not have completion treatment and two (18.2%) in those who did. There were 6 perioperative and 26 postoperative complications. Sixty-three women attempted pregnancy. There were 55 pregnancies in 26 women and 28 live births in 19. Three women had continuing pregnancies. The 5-year cumulative pregnancy rate among women trying to conceive was 52.8%. All but two women were delivered by classical caesarean section and seven (25.0%) babies were born at 31 + 6 weeks or less. Conclusions For selected women with early-stage cervical cancer, radical vaginal trachelectomy and pelvic lymphadenectomy are fertility-sparing options, with a low incidence of recurrence and acceptable cumulative conception rates. Complications are few, although there is a high premature labour and miscarriage rate among pregnant women.Keywords
This publication has 20 references indexed in Scilit:
- Laparoscopically assisted radical vaginal hysterectomy vs. radical abdominal hysterectomy for cervical cancer: a match controlled studyGynecologic Oncology, 2004
- Radical trachelectomy: is it here to stay?Gynecologic Oncology, 2004
- Vaginal radical trachelectomy: an oncologically safe fertility-preserving surgery. An updated series of 72 cases and review of the literatureGynecologic Oncology, 2004
- A review of post‐trachelectomy isthmic and vaginal smear cytologyCytopathology, 2004
- Actinomyces on a papanicolaou smear following a radical trachelectomyBJOG: An International Journal of Obstetrics and Gynaecology, 2003
- La préservation de la fertilité dans les cancers du col utérin de stade précoceGynécologie Obstétrique & Fertilité, 2003
- How Important Is Removal of the Parametrium at Surgery for Carcinoma of the Cervix?Gynecologic Oncology, 2002
- Isthmic stenosis following radical trachelectomyJournal of Obstetrics and Gynaecology, 2002
- Radical trachelectomy in early stage carcinoma of the cervix: outcome as judged by recurrence and fertility ratesBJOG: An International Journal of Obstetrics and Gynaecology, 2001
- Vaginal Radical Hysterectomy versus Abdominal Radical Hysterectomy in the Treatment of Early-Stage Cervical CancerGynecologic Oncology, 1996