Use of Abdominal Radical Trachelectomy to Treat Cervical Cancer Greater Than 2 cm in Diameter

Balázs, Lintner; Saso, Srdjan; Tarnai, László; Novàk, Zoltán; Pálfalvi, László; Priore, Giuseppe Del; Smith, J. R.; Ungár, L.

doi:10.1097/igc.0b013e318295fb41

Cited by 70 publications

(62 citation statements)

References 31 publications

(36 reference statements)

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“…All of these factors provide future challenges for better preoperative selection of patients and appropriate surgical approaches. If the cervical cancer is greater than 2 cm in diameter, ART might be suitable to obtaining good oncological results [26][27][28]. Additionally, cerclages should be carefully placed, and anti-stenosis tools are highly recommended to reduce the incidence of cervical stenosis.…”

Section: Discussionmentioning

confidence: 99%

Incidence, risk factors and treatment of cervical stenosis after radical trachelectomy: A systematic review

Jin

2015

European Journal of Cancer

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Section: Discussionmentioning

confidence: 99%

Incidence, risk factors and treatment of cervical stenosis after radical trachelectomy: A systematic review

Jin

2015

European Journal of Cancer

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“…Another study performed by Wethington et al (12) on 110 patients of stage 1B1, 29 had a tumor size of 2-4 cm; 9 from this group of 29 patients underwent trachelectomy, and after a median follow up of 44 months, there was one recurrence. In a study performed by Lintner et al (13) on 45 patients with FIGO stage 1B1-1B2, all patients with tumor size 2-4 cm had a 5-year survival of 93.5% which is comparable to radical hysterectomy. Most centers include 1B1 tumors with size less than 2 cm only (14).…”

Section: Discussionmentioning

confidence: 99%

“…Of 113 patients who attempted to get pregnant, 67 (59%) were able to conceive (17). Lintner found that the 5 year survival rate was 93.5% and 3 out of 8 patients delivered healthy neonates (18). In a retrospective study done by Lu et al (19), in 25 patients with ear-ly stage cervical cancer treated by laparoscopic RT, there was no intraoperative complications but 3 postoperative complications were observed.…”

Section: Complication Oncologic Safety and Pregnancy Outcome Of Radimentioning

confidence: 99%

Trachelectomy in Early Cervical Cancer

Qudah¹,

Abu²,

Tarek³

et al. 2015

IJWHR

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IntroductionCervical cancer is a malignant neoplasm arising from cells originating in the cervix uteri. It is routinely screened by Papanicolaou's (Pap) smear and human papilloma virus (HPV) is considered as one of its etiological agents. Cervical cancer is the second most common cancer in reproductive age and its diagnosis is increasing in young age as a result of effective and widespread screening programs (1). Cervical cancer is the seventh most common cancer in developed countries. In 2004, around 30,750 new cases of invasive cervical cancer were diagnosed in Europe. In 2012, around 12,170 new cases were discovered in USA and the estimated deaths were 4,220. Unfortunately, the incidence of new cases is much more in developing countries due to inefficient screening programs (2). Due to effective and widespread screening programs and the delay in childbearing age, many women are diagnosed at a time which there is a strong demand for fertility sparing surgery (3). Radical hysterectomy and pelvic lymphadenectomy are the conventional treatment for early stage cervical cancer, but this results in loss of fertility (4). Fertility preservation is one of the most important issues to be discussed with the patient. In the last 20 years, laparascopy assisted radical vaginal trachelectomy (RVT) and radical abdominal trachelectomy have developed that have good documented long term oncological and pregnancy outcome. RVT is a fertility-sparing technique first described by Daniel Dargent in 1994 (5), involving the removal of the cervix, the parametrium, and cuff of vagina, while maintaining the patient's uterine fundus and adnexae. This procedure, in combination with a laparoscopic pelvic lymphadenectomy, is the most common and accepted fertility-sparing procedure for early cervical cancer. RVT begins with laparoscopic pelvic lymphadenectomy. The vaginal procedure is started by circumferential incision in the upper vagina. The supracervical ligament is cut, and the bladder base is mobilized. Posteriorly, the pouch of Douglas is opened and the pararectal spaces are exposed. The uterosacral ligaments are then divided. The vesicovaginal ligaments are then identified, and the paravesical spaces are entered laterally. Then the ureters and uterine arteries are identified. The cardinal ligaments are then divided. The cervix is amputated below the cervical isthmus (5,6). Although RVT associated with laparoscopic pelvic lymphadenectomy is the most used surgical procedure, radical trachelectomy (RT) may be performed either abdominally or vaginally (laparoscopic or robotic). It is estimated that around 40% of candidates for radical hysterectomy can undergo RT, but 12% of these cases will AbstractObjectives: To review the role of trachelectomy as a method of fertility preservation instead of traditional radical hysterectomy in early cervical cancer. Materials and Methods: We conducted our original study through research in PubMed for all original studies and reviews published in the last 10 years. We reviewed the data available on trach...

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“…[3], РАТ можно вы-полнять при IВ1-В2 стадии и размере опухоли более 2 см, при этом частота 5-летней выживаемости составля-ет 93,5%. Безусловно, данная операция, в объем которой входит не только удаление шейки матки и формирование маточно-влагалищного анастомоза, но и удаление пара-метральной клетчатки -выполнение подвздошно-обту-раторной лимфаденэктомии, негативно сказывается на репродуктивном прогнозе у пациенток.…”

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“…Безусловно, данная операция, в объем которой входит не только удаление шейки матки и формирование маточно-влагалищного анастомоза, но и удаление пара-метральной клетчатки -выполнение подвздошно-обту-раторной лимфаденэктомии, негативно сказывается на репродуктивном прогнозе у пациенток. Так, частота на-ступления беременности при выполнении операции от-крытым доступом не превышает 6,6% по отношению ко всем выполненным процедурам [3]. Несколько большая частота наступления беременностей отмечена в исследо-вании H. Nishio и соавт.…”

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