Abdominal radical trachelectomy: a fertility-preserving option for women with early cervical cancer.
Abdominal radical trachelectomy is a fertility-preserving alternative to radical hysterectomy or chemoradiation for young women with stage IA2 to IB cervical cancers. Thirty-three patients were offered this procedure. The mean age was 30.5 years (range 23-37). Three procedures were abandoned because of positive pelvic nodes (two patients) and involvement of the margin between the amputated cervix and uterine fundus (one patient). Of the remaining 30 patients, 10 had stage IA2 tumours, 15 had stage IB1 and 5 had stage IB2. During follow up of a median of 47 months (mean 32 months, range 14-75 months), no recurrences have been detected. A normal menstrual pattern resumed within eight weeks of surgery in all but two patients. Five patients attempted to conceive. Three women have fallen pregnant, resulting in one first trimester miscarriage and two caesarean section deliveries at term. Our experience suggests that abdominal radical trachelectomy provides a method of treating women with stage IA2 to IB cervical cancers with conservation of fertility without apparently compromising recurrence or survival rates. It appears to provide equivalent oncological safety to a standard Wertheim hysterectomy using a technique familiar to all practising gynaecologic oncologists.
Ungár
László
L
Department of Gynaecologic Oncology, St Stephen Hospital, Budapest 1096, Hungary.
Pálfalvi
László
L
Hogg
Russell
R
Siklós
Pál
P
Boyle
Deborah C M
DC
Del Priore
Giuseppe
G
Smith
J Richard
JR
D000328:Adult; D002584:Cervix Uteri / Q000601:surgery*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000517:prevention & control*; D007902:Length of Stay; D008207:Lymphatic Metastasis; D009361:Neoplasm Invasiveness / Q000473:pathology; D010388:Pelvis; D011183:Postoperative Complications / Q000517:prevention & control*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology / Q000601:surgery*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D014621:Vagina / Q000601:surgery*