Neoadjuvant intra-arterial chemotherapy followed by total laparoscopic radical trachelectomy in stage IB1 cervical cancer.
OBJECTIVE
To support the feasibility and safety of neoadjuvant intra-arterial chemotherapy followed by total laparoscopic radical trachelectomy in stage IB1 cervical cancer with tumor larger than 2 cm.


METHODS
A retrospective study.


METHODS
University-affiliated gynecologic oncology department.


METHODS
Patients with stage IB1 cervical cancer with tumor size larger than 2 cm who wish to preserve fertility.


METHODS
Neoadjuvant intra-arterial chemotherapy followed by laparoscopic radical trachelectomy.


METHODS
Data regarding neoadjuvant chemotherapy operational time, blood loss, recurrence, and subsequent pregnancies were recorded. Other published reports on neoadjuvant chemotherapy followed by radical trachelectomy were reviewed.


RESULTS
Seven patients had a laparoscopic radical trachelectomy after neoadjuvant intra-arterial chemotherapy for stage IB1 cervical cancer. Median tumor diameter evaluated by colposcopy was 3.3 cm (range, 2.5-4.0 cm), tumor histotype was all squamous. All patients showed complete or partial response to neoadjuvant chemotherapy, and they were all treated with total laparoscopic radical trachelectomy. One patient had no menses after treatment. After a median 66 months (range, 12-90 months) of follow-up time, no recurrence was observed. Only four patients attempted to conceive and two succeeded.


CONCLUSIONS
Neoadjuvant intra-arterial chemotherapy followed by total laparoscopic radical trachelectomy may become a useful option for women with cervical cancer with a tumor size larger than 2 cm who wish to preserve fertility. Ovarian protection warrants further investigation.
Department of Obstetrics and Gynecology, Chao-yang Hospital, Capital Medical University, Beijing, People's Republic of China.
Qi
Q
Lu
Department of Obstetrics and Gynecology, China Aerospace Science & Industry Corporation 731 Hospital, Beijing, People's Republic of China.
Yunhe
Y
Zhang
Department of Obstetrics and Gynecology, Chao-yang Hospital, Capital Medical University, Beijing, People's Republic of China.
Shuzhen
S
Wang
Department of Obstetrics and Gynecology, Chao-yang Hospital, Capital Medical University, Beijing, People's Republic of China.
Shuli
S
Guo
Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, People's Republic of China.
Hongyan
H
Guo
Department of Obstetrics and Gynecology, Chao-yang Hospital, Capital Medical University, Beijing, People's Republic of China. Electronic address: zhenyuzhang2000@163.com.
Zhenyu
Z
Zhang
Department of Obstetrics and Gynecology, Chao-yang Hospital, Capital Medical University, Beijing, People's Republic of China.
Chongdong
C
Liu
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001761:Bleomycin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial; D010535:Laparoscopy / Q000379:methods*; D016685:Mitomycin / Q000008:administration & dosage; D020360:Neoadjuvant Therapy / Q000379:methods*; D009367:Neoplasm Staging; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*
D001761:Bleomycin; D016685:Mitomycin; D002945:Cisplatin
Neoadjuvant chemotherapy; cervical cancer; fertility preservation; ovarian function protection; total laparoscopic radical trachelectomy