Fertility-Sparing Surgery for Early Cervical Cancer—Approach to Less Radical Surgery

Raju, Shanti; Papadopoulos, A.; Montalto, Stephen Attard; Coutts, Michael; Culora, G.; Kodampur, M.; Mehra, Gautam; Devaja, Omer

doi:10.1097/igc.0b013e3182370f51

Cited by 65 publications

(37 citation statements)

References 17 publications

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“…Fertilitysparing surgical options, such as laparoscopic (LRT), abdominal (ART) and vaginal radical trachelectomy (VRT) or simple trachelectomies with or without pelvic lymphadenectomy, have been reported. [2,3,4,5] A study of Schmeler et al showed that 60% of trachelectomy specimens did not contain residual invasive malignant disease, [6,7,8,9,10] which raises the question if less radical surgery is possible in some cases. Furthermore, trachelectomies have been associated with preterm deliveries (before 31 weeks) in about one third of the patients.…”

Section: Introductionmentioning

confidence: 97%

Neoadjuvant chemotherapy followed by large cone resection as fertility-sparing therapy in stage IB cervical cancer

Salihi

Leunen

Limbergen

et al. 2015

Gynecologic Oncology

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Section: Introductionmentioning

confidence: 97%

Neoadjuvant chemotherapy followed by large cone resection as fertility-sparing therapy in stage IB cervical cancer

Salihi

Leunen

Limbergen

et al. 2015

Gynecologic Oncology

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“…Cervical stenosis does not necessarily result in infertility, and may be avoidable, depending on the technique employed 6 24. The overall calculable infertility rate of 17.9% in motivated women is only marginally higher than in the general population,3 6 7 and this figure may have been affected by factors not applicable to this case, such as radiotherapy treatment.…”

Section: Discussionmentioning

confidence: 86%

“…Rob et al advocate the use of prophylactic antibiotics during pregnancy to minimise this risk, as the only case of PROM in their study occurred when antibiotic prophylaxis was ignored 7. Other authors do not concur; infection was not listed as a complication in the other three studies where antibiotics were not administered and, in Rob et al 's case, there may have been other confounding factors that predisposed to a poorer outcome 5–7.…”

Section: Discussionmentioning

confidence: 99%

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Simple vaginal trachelectomy as a fertility-sparing treatment to manage high-grade dyskaryosis following multiple large loop excision of the transformation zone

2016

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SUMMARYA 34-year-old nullipara, wishing to start a family, presented to colposcopy clinic. Her most recent cervical cytology result showed high-grade dyskaryosis. Having undergone four large loop excisions of the transformation zone during the past 6 years, this woman had no remaining vaginal cervix. In order to excise presumed high-grade cervical intraepithelial neoplasia while mitigating obstetric risk, she underwent a simple vaginal trachelectomy and isthmic cerclage. 6 months later, the patient had a negative test of cure. 7 months following surgery she became pregnant naturally. At 29 weeks she had antenatal sepsis of unknown cause, which was treated with intravenous antibiotics. She delivered by caesarean section at 37 weeks and now has a healthy child. This report will discuss the obstetric impact of colposcopic treatment, and simple vaginal trachelectomy as a fertility-sparing treatment option for women who have had multiple loop excision procedures to treat premalignant lesions. BACKGROUND

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“…However, the morbidity related to treatment was reduced and the potential for fertility increased in the group submitted to simple trachelectomy 32 .…”

Section: Laparoscopic Lymphadenectomy Laparoscopic Lymphadenectomy Lamentioning

confidence: 99%

Laparoscopy in uterine cervical cancer. Current state and literature review

Tsunoda

Andrade

Vieira

et al. 2015

Rev. Col. Bras. Cir.

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ABSTRACT ABSTRACT ABSTRACTCervical cancer remains the most frequent gynecological tumor in Brazil and other developing countries. Minimally invasive techniques, especially laparoscopy, have been increasingly employed in such tumors. This article aims to describe the main applications of laparoscopy in the treatment and staging of cervical cancer. In the early stages, it is possible to provide a fertilitypreserving surgery in the form of radical trachelectomy and, in a study protocol, the function-preserving surgery, avoiding parametrectomy and the associated morbidity. A fully laparoscopic radical hysterectomy is fairly standard in the literature and has the tendency to become the standard of care in early cases, for patients who want to bear no more children. In advanced stages, minimally invasive surgery can offer ovarian transposition, with intent to prevent actinic castration, without upsetting the time for the start of radiotherapy and chemotherapy. Staging laparoscopic surgery, including pelvic and para-aortic lymphadenectomy, has been the subject of studies, since it has the potential to modify the extension of radiotherapy depending on the extent of lymph node spread.

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Fertility-Sparing Surgery for Early Cervical Cancer—Approach to Less Radical Surgery

Abstract: It is possible to select patients for a less radical fertility-sparing procedure through identification of measurable low-risk factors and thus reduce the morbidity caused by conventional RVT. The selection criteria should be stringent and applied within the setting of a cancer center.

Cited by 65 publications

References 17 publications

Neoadjuvant chemotherapy followed by large cone resection as fertility-sparing therapy in stage IB cervical cancer

Neoadjuvant chemotherapy followed by large cone resection as fertility-sparing therapy in stage IB cervical cancer

Simple vaginal trachelectomy as a fertility-sparing treatment to manage high-grade dyskaryosis following multiple large loop excision of the transformation zone

Laparoscopy in uterine cervical cancer. Current state and literature review

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