Follow-up after radical vaginal trachelectomy (RVT): patients’ problems and physicians’ difficulties

Speiser, Dorothee; Malik, Shazia; Lanowska, Malgorzata; Bartens, Anne; Blohmer, Jens-Uwe; Mangler, Mandy

doi:10.1007/s00404-017-4463-0

Cited by 3 publications

(5 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, radical trachelectomy has some morbidities. Removal of unnecessary endocervical canal may lead to cervical stenosis in those patients [7]. Abortion and second trimester miscarriages are more than 70% in patients underwent abdominal radical trachelectomy.…”

Section: Introductionmentioning

confidence: 99%

“…Abortion and second trimester miscarriages are more than 70% in patients underwent abdominal radical trachelectomy. In addition, parametrectomy is responsible for the majority of surgical complications such as intraoperative significant blood loss, bladder and bowel dysfunction, fistula formation, and sexual dysfunction [7,8]. On the other hand, very low rate of parametrial involvement and recurrence in patients with cervical tumor ≤ 2 cm has been reported in many studies [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Simple vaginal trachelectomy for early stage cervical cancer: A tertiary cancer center experience

Demirkıran¹,

Kahramanoğlu²,

Beşe³

et al. 2018

Ginekol Pol

View full text Add to dashboard Cite

Objectives: Less radical fertility sparing procedures have been introduced to reduce morbidity and adverse obstetric outcome in cervical cancer. Our objective was to describe oncological and obstetric outcomes of women with early-stage cervical cancer who underwent a simple vaginal trachelectomy (SVT). Material and methods: From 01/2013 to 05/2017, 14 women underwent SVT preceded by laparoscopic pelvic lymph node dissection. Results: Patients' median age was 32 years and all of them were nulliparous. Histology included squamous cell carcinoma and adenocarcinoma in 12 (85.7%) and 2 (14.3%) patients, respectively. Three patients had stage 1A1 with lymphovascular space invasion, 4 1A2 and 7 1B1. After obtaining final histopathology, one patient underwent radical hysterectomy due to positive surgical margin and excluded from analysis. None of the patients had lymph node metastasis. None of the 13 patients developed a recurrence within a median follow-up of 27 (6-56) months. Seven patients have conceived: 4 were term deliveries, 2 were late preterm deliveries and 1 was spontaneous abortion. Conclusions: SVT in well selected early-stage cervical cancer patients seems to be a safe treatment option with excellent oncologic outcome, preserving reproductive function. Literature data will need to be confirmed in large prospective series.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Simple vaginal trachelectomy for early stage cervical cancer: A tertiary cancer center experience

Demirkıran¹,

Kahramanoğlu²,

Beşe³

et al. 2018

Ginekol Pol

View full text Add to dashboard Cite

show abstract

“…In this case, menstruation had stopped owing to the MPA therapy, which may have made cervical stenosis more likely to occur owing to the lack of menstrual blood drainage. Intrauterine devices are reported to prevent cervical stenosis after RT and should be actively considered in cases where cervical stenosis is a problem, as in this case 14,15 …”

Section: Discussionmentioning

confidence: 97%

“…Intrauterine devices are reported to prevent cervical stenosis after RT and should be actively considered in cases where cervical stenosis is a problem, as in this case. 14,15 The patient overcame the two diseases and gave birth to a son, but the possibility of recurrence still exists. AEH can recur even after remission and a live (c) The infant's head had descended so far that the shoulder and arm were visible just below the uterine incision.…”

Section: Discussionmentioning

confidence: 99%

Achievement of live birth after overcoming two gynecological malignancies treated with radical trachelectomy and medroxyprogesterone acetate therapy

Tamauchi

Moriyama

Suzuki

et al. 2021

J of Obstet and Gynaecol

View full text Add to dashboard Cite

Cervical cancer is a human papilloma virus-related disease, whereas endometrial cancer and atypical endometrial hyperplasia (AEH) are hormone-related diseases, so co-occurrence of the two is possible. However, scientific studies about such cases are rare. We encountered a case of cervical adenocarcinoma and AEH in a 33-year-old nulliparous woman. Two fertility-sparing treatments were performed, a radical trachelectomy for the cervical cancer and high-dose medroxyprogesterone acetate treatment for the AEH. After remission of the diseases, the patient became pregnant by in vitro fertilization and delivered a baby at 36 weeks' gestation by cesarean section. Although the patient had two uterine malignancies, proper evaluation of the diseases, consultation with the patient and her husband, and appropriate management led to fertility preservation, and live birth was achieved.

show abstract

“…Following these findings, accurately selecting patients who wish to preserve fertility for either radical trachelectomy or more conservative approaches is of increasing clinical importance. As evidence of oncologic and obstetrical outcomes following radical abdominal trachelectomies in Germany and Austria is currently limited, and only few tertiary care centers in Central Europe perform the procedure, the present study aimed to retrospectively assess patients who underwent radical abdominal trachelectomies at the Department of Obstetrics and Gynaecology, Medical University of Vienna, Austria, over a timeframe of 10 years and contextualize outcomes and patient selection according to more recently proposed “low-risk” criteria [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Oncologic and Obstetric Outcomes Following Radical Abdominal Trachelectomy in Non-Low-Risk Early-Stage Cervical Cancers: A 10-Year Austrian Single-Center Experience

Danisch,

Kranawetter,

Bartl

et al. 2024

JPM

View full text Add to dashboard Cite

Radical trachelectomy allows for fertility preservation in patients with early cervical cancer not qualifying as “low-risk” as defined by ConCerv. This study reports on the 10-year surgical, oncological, and obstetrical experience of patients treated by radical abdominal trachelectomy at an Austrian tertiary care center. A retrospective chart analysis and telephone survey of all patients with FIGO stage IA2-IB2 (2018) cervical cancer treated by radical abdominal trachelectomy and pelvic lymphadenectomy between 2013 and 2022 were performed. Radical abdominal trachelectomy was attempted in 29 patients, of whom 3 patients underwent neoadjuvant chemotherapy. Three cases, including one after neoadjuvant therapy, required conversion to radical hysterectomy due to positive margins; four cases had positive lymph nodes following surgical staging and were referred to primary chemo-radiotherapy. Twenty-two (75.9%) successful abdominal radical trachelectomies preserving fertility were performed. According to final histopathology, 79.3% of tumors would not have met the “low-risk”-criteria. At a median follow-up of 64.5 (25.5–104.0) months, no recurrence was observed. Eight (36.4%) patients attempted to conceive, with a live birth rate of 62.5%. Radical abdominal trachelectomy appears oncologically safe in early-stage cervical cancers that do not fulfill the “low-risk”-criteria. Strict preoperative selection of patients who might qualify for more conservative surgical approaches is strongly recommended.

show abstract

Follow-up after radical vaginal trachelectomy (RVT): patients’ problems and physicians’ difficulties

Abstract: Follow-up of patients after RVT needs special expertise because the symptoms differ from those after hysterectomy and examinations ensuring oncologic safety require special attention.

Cited by 3 publications

References 18 publications

Simple vaginal trachelectomy for early stage cervical cancer: A tertiary cancer center experience

Simple vaginal trachelectomy for early stage cervical cancer: A tertiary cancer center experience

Achievement of live birth after overcoming two gynecological malignancies treated with radical trachelectomy and medroxyprogesterone acetate therapy

Oncologic and Obstetric Outcomes Following Radical Abdominal Trachelectomy in Non-Low-Risk Early-Stage Cervical Cancers: A 10-Year Austrian Single-Center Experience

Contact Info

Product

Resources

About