title: Pregnancy after lymphadenectomy and neoadjuvant chemotherapy followed by radical vaginal trachelectomy in FIGO stage IB1 cervical cancer.
abstract: OBJECTIVE
  To report a case of full-term delivery after laparoscopic lymphadenectomy and neoadjuvant chemotherapy followed by radical vaginal trachelectomy in bulky stage IB1 cervical cancer.
  
  
  METHODS
  Case report.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  A 27-year-old woman with adenosquamous cervical cancer stage IB1 (4 cm in diameter) that was diagnosed in December 2005. She expressed a wish for fertility-sparing treatment.
  
  
  METHODS
  A laparoscopic pelvic and para-aortic lymphadenectomy was performed and showed no evidence of lymphatic metastasis. The patient subsequently received chemotherapy with Paclitaxel 200 mg/m2 and Cisplatin 100 mg/m2. The treatment cycle was repeated after 3 weeks with Cisplatin reduced to 50 mg/m2, because of creatinine-increase. Radical vaginal trachelectomy was then performed. After histologic examination, carcinoma of only 2 mm in diameter was found in the final specimen.
  
  
  METHODS
  Oncologic and fertility outcome after neoadjuvant chemotherapy and radical vaginal trachelectomy.
  
  
  RESULTS
  The patient resumed a normal menstrual pattern 6 weeks after surgery. In December 2008, she conceived and carried and infant to full term. Antenatally, she reported no problems during pregnancy except for gestational insulin-dependent diabetes. She gave birth to a baby boy at 38 weeks' gestation by caesarean section. The newborn (weight, 3500 g; length, 52 cm; Apgar scores, 5/8/10; pH value, 7.28) was monitored in a neonatal ward for 24 hours. The patient is currently under outpatient review and has had 5 years of follow-up with no evidence of recurrence.
  
  
  CONCLUSIONS
  Neoadjuvant chemotherapy followed by a fertility-sparing surgery may become a valuable option for women with bulky-stage cervical cancer who wish to preserve their fertility potential.
authors.affiliation: Department of Gynecology, Charité Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Gottschalk
authors.forename: Mandy
authors.initials: M
authors.lastname: Mangler
authors.forename: Achim
authors.initials: A
authors.lastname: Schneider
authors.forename: Christhardt
authors.initials: C
authors.lastname: Koehler
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Lanowska
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D018196:Carcinoma, Adenosquamous / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D005298:Fertility / Q000187:drug effects; D013509:Gynecologic Surgical Procedures; D006801:Humans; D010535:Laparoscopy; D050498:Live Birth; D008197:Lymph Node Excision / Q000379:methods*; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage; D011247:Pregnancy; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000628:therapy*
chemical_list: D017239:Paclitaxel; D002945:Cisplatin