title: Abdominal radical trachelectomy in West London.
abstract: OBJECTIVE
  Traditionally, the surgical management of invasive cervical carcinoma that has progressed beyond microinvasion has been a radical abdominal hysterectomy. However, this results in the loss of fertility, with significant consequences for the young patient. This report describes abdominal radical trachelectomy (ART) as a potential replacement for radical hysterectomy in patients with stage IA2-IIA cervical cancer who desire a fertility-sparing procedure without decreasing the curative rates.
  
  
  METHODS
  Observational, retrospective study.
  
  
  METHODS
  Teaching hospital and regional cancer centre in London, UK.
  
  
  METHODS
  Patients undergoing ART.
  
  
  METHODS
  Patients presenting during the period 2000-2009 with cervical cancer stage IA2-IIA were offered a trachelectomy, if they expressed a desire to preserve fertility. The type of trachelectomy (vaginal/abdominal) was chosen based on patient anatomy and neoplastic and magnetic resonance imaging characteristics. Each patient was counselled as to the experimental nature of the procedure.
  
  
  METHODS
  Survival, recurrence and fertility issues among ART patients.
  
  
  RESULTS
  A total of 30 patients underwent ART (open and laparoscopic) between 2001 and 2009. Three patients presented with a recurrence, two of which have died (median follow-up: 24 months). Only three patients required further surgical re-intervention because of operative complications. Ten patients attempted to conceive, resulting in three conceptions (30%) and two live children.
  
  
  CONCLUSIONS
  Abdominal radical trachelectomy provides a feasible, cost-effective and safe treatment option for young women who have been diagnosed with early-stage cervical cancer and wish to preserve their fertility.
authors.affiliation: Department of Surgery and Cancer, Institute of Reproductive & Developmental Biology, London, UK. srdjan.saso@imperial.ac.uk
authors.forename: S
authors.initials: S
authors.lastname: Saso
authors.forename: S
authors.initials: S
authors.lastname: Ghaem-Maghami
authors.forename: J
authors.initials: J
authors.lastname: Chatterjee
authors.forename: O
authors.initials: O
authors.lastname: Naji
authors.forename: A
authors.initials: A
authors.lastname: Farthing
authors.forename: P
authors.initials: P
authors.lastname: Mason
authors.forename: A
authors.initials: A
authors.lastname: McIndoe
authors.forename: V
authors.initials: V
authors.lastname: Hird
authors.forename: L
authors.initials: L
authors.lastname: Ungar
authors.forename: G
authors.initials: G
authors.lastname: Del Priore
authors.forename: J R
authors.initials: JR
authors.lastname: Smith
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000601:surgery*; D015925:Cryopreservation; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000517:prevention & control; D008131:London / Q000453:epidemiology; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery; D054315:Oocyte Retrieval; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000601:surgery; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D012086:Reoperation; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000601:surgery*