title: Surgical, oncological, and obstetrical outcomes after abdominal radical trachelectomy - a systematic literature review.
abstract: OBJECTIVE
  Radical trachelectomy is a standard treatment for selected patients with early-stage cervical cancer. Outcomes are well established for vaginal radical trachelectomy (VRT), but not for abdominal radical trachelectomy (ART).
  
  
  METHODS
  We searched MEDLINE, EMBASE, and CINAHL (October 1997 through October 2012) using the terms: uterine cervix neoplasms, cervical cancer, abdominal radical trachelectomy, vaginal radical trachelectomy, fertility sparing, and fertility preservation. We included original articles, case series, and case reports. Excluded were review articles, articles with duplicate patient information, and articles not in English.
  
  
  RESULTS
  We identified 485 patients. Ages ranged from 6 to 44 years. The most common stage was IB1 (331/464; 71%), and the most common histologic subtype was squamous cell carcinoma (330/470; 70%). Operative times ranged from 110 to 586 min. Blood loss ranged from 50 to 5568 mL. Three intraoperative complications were reported. Forty-seven patients (10%) had conversion to radical hysterectomy. One hundred fifty-five patients (35%) had a postoperative complication. The most frequent postoperative complication was cervical stenosis (n=42; 9.5%). The median follow-up time was 31.6 months (range, 1-124). Sixteen patients (3.8%) had disease recurrence. Two patients (0.4%) died of disease. A total of 413 patients (85%) were able to maintain their fertility. A total of 113 patients (38%) attempted to get pregnant, and 67 of them (59.3%) were able to conceive.
  
  
  CONCLUSIONS
  ART is a safe treatment option in patients with early-stage cervical cancer interested in preserving fertility.
authors.affiliation: Department of Gynecologic Oncology, Instituto de Cancerología Las Américas, Medellín, Colombia.
authors.forename: René
authors.initials: R
authors.lastname: Pareja
authors.forename: Gabriel J
authors.initials: GJ
authors.lastname: Rendón
authors.forename: Carlos Millán
authors.initials: CM
authors.lastname: Sanz-Lomana
authors.forename: Otto
authors.initials: O
authors.lastname: Monzón
authors.forename: Pedro T
authors.initials: PT
authors.lastname: Ramirez
mesh_terms: D000005:Abdomen / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D059247:Fertility Preservation; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects; D006801:Humans; D009364:Neoplasm Recurrence, Local; D011247:Pregnancy; D018873:Pregnancy Rate; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: Abdominal radical trachelectomy; Cervical cancer; Fertility preservation; Fertility sparing