Abdominal radical trachelectomy as a fertility-sparing procedure in women with early-stage cervical cancer in a series of 61 women.
OBJECTIVE
This retrospective study was conducted as a review of a series of women who had undergone abdominal radical trachelectomy and pelvic lymphadenectomy for early-stage cervical cancer.


METHODS
We performed a retrospective review of patients who had undergone an abdominal radical trachelectomy. Data regarding tumor size and histology, surgical complications, recurrences, pregnancies and live births were collected and were presented as a percentage of the total number of cases.


RESULTS
A total of 61 women were followed up for a median of 27 months (range: one month--79 months). There were six recurrences (9.8%); none of the recurrences occurred in patients with a tumor diameter of <20 mm except in one case with adenocarcinoma. Twenty-nine women attempted to conceive; four of these women were successful. All four of these women had live births: two had preterm deliveries, and the remaining two had full-term deliveries. The cumulative pregnancy rate among the women who attempted to conceive was 13.8% (4/29).


CONCLUSIONS
Among selected women with early-stage cervical cancer, especially those with a tumor diameter of <20 mm, abdominal radical trachelectomy and pelvic lymphadenectomy is a fertility-sparing treatment option, even though the cumulative conception rate was not particularly high compared with that for women who had undergone a vaginal radical trachelectomy.
Nishio
Hiroshi
H
Department of Obstetrics and Gynecology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Fujii
Takuma
T
Department of Obstetrics and Gynecology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. Electronic address: fujiit@sc.itc.keio.ac.jp.
Kameyama
Kaori
K
Department of Pathology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Susumu
Nobuyuki
N
Department of Obstetrics and Gynecology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Nakamura
Masaru
M
Department of Obstetrics and Gynecology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Iwata
Takashi
T
Department of Obstetrics and Gynecology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Aoki
Daisuke
D
Department of Obstetrics and Gynecology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005298:Fertility; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D009367:Neoplasm Staging; D011247:Pregnancy; D018873:Pregnancy Rate; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*