Radical trachelectomy and pelvic lymphadenectomy with uterine preservation in the treatment of cervical cancer.
OBJECTIVE
The purpose of this study was to determine whether radical trachelectomy, combined with pelvic lymphadenectomy, can be a feasible method for the treatment of early-stage cervical carcinoma in women who want to preserve their fertility.


METHODS
From January 1, 1995, through December 31, 1999, 12 women with stage I carcinoma of the cervix were scheduled to undergo radical trachelectomy and pelvic lymphadenectomy of the intact uterus as treatment. The procedure was abandoned in 2 women because of endometrial extension of the cancer. Surgical margins were clear in all other women. No lymph node metastases were encountered. The proximal cervical remnant was reinforced in 10 women.


RESULTS
Hospitalization ranged from 2 to 8 days (mean, 3.2 days). Estimated blood loss averaged 203 mL (range, 50-600 mL). Complications included 2 intraoperative cystotomies and 1 pelvic hematoma. Four pregnancies have occurred, with 2 third-trimester deliveries and 2 preterm losses at 24 and 26 weeks of gestation, respectively. The follow-up period has ranged from 28 to 84 months (mean, 47.6 months).


CONCLUSIONS
Radical trachelectomy, combined with pelvic lymphadenectomy, can be a feasible method of treatment for early-stage cervical carcinoma in women who want to preserve their fertility.
Schlaerth
John B
JB
Women's Cancer Center, Pasadena, CA 91107, USA.
Spirtos
Nicola M
NM
Schlaerth
Alan C
AC
D000328:Adult; D016063:Blood Loss, Surgical; D002584:Cervix Uteri / Q000601:surgery*; D005260:Female; D005298:Fertility; D006801:Humans; D007044:Hysterectomy; D007431:Intraoperative Complications; D010535:Laparoscopy; D007902:Length of Stay; D008197:Lymph Node Excision; D009367:Neoplasm Staging; D010388:Pelvis; D011247:Pregnancy; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D014599:Uterus / Q000473:pathology