title: Long-term outcomes after fertility-sparing laparoscopic radical trachelectomy in young women with early-stage cervical cancer: an Asan Gynecologic Cancer Group (AGCG) study.
abstract: OBJECTIVE
  To evaluate the long-term outcomes and risk factors for recurrence after fertility-sparing laparoscopic radical trachelectomy (LRT) in young women with early-stage cervical cancer.
  
  
  METHODS
  Eighty-eight consecutive patients from four tertiary cancer centers in Korea who had attempted fertility-sparing LRT for early-stage cervical cancer were included in this study.
  
  
  RESULTS
  Seventy-nine patients completed LRT. The mean age and tumor size were 31 years (range, 20-40 years) and 1.8 cm (range, 0.4-7 cm), respectively. Twenty-nine patients had a tumor size greater than 2 cm, 22 had deep stromal invasion greater than 50%, and twelve had lymphovascular space invasion. After a median follow-up time of 44 months (range, 3-105 months), nine patients had recurrence and one had died of disease. A tumor size greater than 2 cm (P = 0.039) and a depth of stromal invasion greater than 50% (P = 0.016) were significant risk factors for recurrence.
  
  
  CONCLUSIONS
  This is the largest series on fertility-sparing LRT in young women with early cervical cancer. LRT is a feasible and safe fertility-sparing alternative to radical hysterectomy in these women. A tumor size greater than 2 cm and a depth of stromal invasion greater than 50% were risk factors for recurrence.
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Jeong-Yeol
authors.initials: JY
authors.lastname: Park
authors.forename: Won Deok
authors.initials: WD
authors.lastname: Joo
authors.forename: Suk-Joon
authors.initials: SJ
authors.lastname: Chang
authors.forename: Dae-Yeon
authors.initials: DY
authors.lastname: Kim
authors.forename: Jong-Hyeok
authors.initials: JH
authors.lastname: Kim
authors.forename: Yong-Man
authors.initials: YM
authors.lastname: Kim
authors.forename: Young-Tak
authors.initials: YT
authors.lastname: Kim
authors.forename: Joo-Hyun
authors.initials: JH
authors.lastname: Nam
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002584:Cervix Uteri / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D005260:Female; D059247:Fertility Preservation; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D050498:Live Birth; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D011247:Pregnancy; D018873:Pregnancy Rate; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D055815:Young Adult
keywords: early cervical cancer; laparoscopic radical trachelectomy; recurrence; risk factor