Outcomes of abdominal radical trachelectomy: results of a multicenter prospective cohort study in a Tohoku Gynecologic Cancer Unit.
BACKGROUND
This study aimed to evaluate surgical, pregnancy, and prognostic outcomes of radical abdominal trachelectomy (RAT) for Japanese patients with early-stage cervical cancer.


METHODS
This was a multicenter prospective cohort study conducted in member facilities of Tohoku Gynecologic Cancer Unit. Patients with FIGO 1A-1B1 squamous cell carcinoma were included.


RESULTS
A total of 42 patients were registered in this study, and all patients underwent planned RAT. The median stromal invasion and median horizontal spread of resected specimens were 4.6 (range 1.0-10.0) and 12.4 mm (range 3.0-28.0), respectively. The median surgical time and median blood loss were 304 min (range 233-611) and 848 mL (range 250-3984), respectively. Five patients (11.9 %) received blood transfusion. Five of 18 (27.8 %) patients who attempted to conceive achieved pregnancy, and 3 patients had healthy babies. However, all pregnancies required assisted reproductive technology with in-vitro fertilization and embryo transfer. Four patients (9.5 %) received postoperative adjuvant therapy, and 3 patients (7.1 %) developed disease recurrence.


CONCLUSIONS
RAT may be safely performed for Japanese patients with FIGO 1A-1B1 squamous cell carcinoma of the cervix, even in educational medical facilities. However, less-invasive surgery should be considered more often to improve pregnancy outcomes.
Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Hideki
H
Tokunaga
Yoh
Y
Watanabe
Hitoshi
H
Niikura
Satoru
S
Nagase
Masafumi
M
Toyoshima
Reiji
R
Shiro
Yoshihito
Y
Yokoyama
Hideki
H
Mizunuma
Tsuyoshi
T
Ohta
Hiroshi
H
Nishiyama
Takafumi
T
Watanabe
Naoki
N
Sato
Naoto
N
Sato
Toru
T
Sugiyama
Tadao
T
Takano
Fumiaki
F
Takahashi
Nobuo
N
Yaegashi
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D011446:Prospective Studies; D000069339:Trachelectomy / Q000379:methods*; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D055815:Young Adult