title: Radical Trachelectomy for Early-Stage Cervical Cancer: A Survey of the Society of Gynecologic Oncology and Gynecologic Oncology Fellows-in-Training.
abstract: OBJECTIVE
  The aim of this study was to survey gynecologic oncologists and fellows-in-training regarding the role of radical trachelectomy (RT) and conservative surgery in patients with early-stage cervical cancer.
  
  
  METHODS
  From June 2012 to September 2012, the Society of Gynecologic Oncology member practitioners (n = 1353) and gynecologic oncology fellows (n = 156) were sent group-specific surveys investigating current practice, training, and the future of RT for early-stage cervical cancer management.
  
  
  RESULTS
  Twenty-two percent of practitioners (n = 303) and 24.4% of fellows (n = 38) completed the surveys. Of the practitioners, 50% (n = 148) report performing RT, 98% (n = 269) support RT as treatment for squamous carcinoma, and 71% (n = 195) confirm the use of RT for adenocarcinoma. Most practitioners offer RT treatment for stages IA2 to IB1 smaller than 2 cm (n = 209, 76.8%) regardless of grade (77.7%) or lymph vascular space invasion (n = 211, 79.3%). Only 8% (n = 23) of practitioners feel that RT is appropriate for stage IBI larger than 2 cm. Respectively, both practitioners and fellows most frequently perform robotic-assisted (47.0%, n = 101 and 59.1%, n = 13) and abdominal (40.5%, n = 87 and 68.2%, n = 15) RT approaches. After training, fellows project the use of robotic-assisted (71%, n = 22) or abdominal methods (58.1%, n = 18). Overall, 75% (n = 227) of practitioners and 60% (n = 23) of fellows speculate that over the next 5 years, less radical procedures will be used to manage early-stage cervical cancer.
  
  
  CONCLUSIONS
  Our findings suggest that practitioners and fellows believe RT remains an option for early-stage cervical cancer patients. However, a significant proportion of all respondents believe that less radical surgery may be a future consideration for patients with low-risk early-stage cervical cancer.
authors: *Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA; †Department of Obstetrics and Gynecology, Summa Health System, Akron, OH; ‡Division of Surgery, Department of Gynecologic Oncology and Reproductive Medicine, and §Department of Institutional Research, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors: Sara J
authors: SJ
authors: Churchill
authors: Shannon
authors: S
authors: Armbruster
authors: Kathleen M
authors: KM
authors: Schmeler
authors: Michael
authors: M
authors: Frumovitz
authors: Marilyn
authors: M
authors: Greer
authors: Jaime
authors: J
authors: Garcia
authors: Glenda
authors: G
authors: Redworth
authors: Pedro T
authors: PT
authors: Ramirez
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D018262:Adenocarcinoma, Clear Cell / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D018284:Cystadenocarcinoma, Serous / Q000473:pathology / Q000601:surgery; D019468:Disease Management; D004503:Education, Medical, Graduate / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000193:education* / Q000592:standards; D008875:Middle Aged; D009367:Neoplasm Staging; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D000069339:Trachelectomy / Q000193:education* / Q000592:standards; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*