title: [Oncologic and fertility outcomes of young patients with early stage of cervical cancer treated by vaginal radical trachelectomy].
abstract: OBJECTIVE
  To evaluate the prognosis and fertility outcomes of patients with early stage of cervical cancer treated by vaginal radical trachelectomy (VRT) in combination with laparoscopic pelvic lymphadenectomy.
  
  
  METHODS
  The surgical data, disease recurrences and fertility outcomes were analyzed retrospectively for 51 patients who received VRT in Peking Union Medical College Hospital from Dec. 2003 to Nov. 2013.
  
  
  RESULTS
  Forty-eight patients succeeded in preserving fertility. The median age was 29 years. International Federation of Gynecology and Obstetrics (FIGO) stage: 5 cases Ia1 with lymph vascular space invasion (LVSI), 4 cases Ia2 and 39 cases in stage Ib1. Tumor size: 20 cases with no visible lesion, 20 cases with tumor size ≤ 2 cm, 8 cases with tumor size > 2 cm. Histological type: 42 cases with squamous carcinoma, 6 cases with adenocarcinoma or adeno-squamous carcinoma. The mean excised cervical length and parametrial width was (2.6 ± 0.6) cm and (1.9 ± 0.5) cm, respectively. Six recurrences (12%) were observed after following up for a mean duration of (35 ± 21) months. The recurrent rate in patients with tumor size > 2 cm was 3/8, which was significantly higher than that of the patients with tumor size ≤ 2 cm (8%, 3/40;P < 0.01). Of the 35 patients who desired to conceive after the surgery, 13 women had 17 pregnancies and the pregnant rate was 37% (13/35). Nine women obtained 10 healthy live birth babies. The fertility rate was 26% (9/35).
  
  
  CONCLUSIONS
  VRT in combination with laparoscopic pelvic lymphadenectomy could preserve the fertility of patients with early stage of cervical cancer with acceptable oncologic and fertility outcomes. Tumor size ≤ 2 cm should be emphasized as the indication of VRT in considering of the higher recurrent rate in patients with tumor size > 2 cm.
authors: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors: Dongyan
authors: D
authors: Cao
authors: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors: Jiaxin
authors: J
authors: Yang
authors: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors: Yang
authors: Y
authors: Xiang
authors: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors: Ming
authors: M
authors: Wu
authors: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors: Lingya
authors: L
authors: Pan
authors: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors: Huifang
authors: H
authors: Huang
authors: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors: Jinghe
authors: J
authors: Lang
authors: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China. Email: shenkeng@vip.sina.com.
authors: Keng
authors: K
authors: Shen
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000379:methods*; D010535:Laparoscopy; D008197:Lymph Node Excision; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D014621:Vagina / Q000601:surgery*