Is radical trachelectomy a safe alternative to radical hysterectomy for patients with Stage IA-B carcinoma of the cervix?

Covens, Allan; Shaw, Patricia; Murphy, Joan; DePetrillo, Denny; Lickrish, Gordon M.; Laframboise, Stéphane; Rosen, Barry P.

doi:10.1002/(sici)1097-0142(19991201)86:11<2273::aid-cncr15>3.0.co;2-c

Cited by 227 publications

(130 citation statements)

References 15 publications

(15 reference statements)

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“…Excluding those who had abandoned procedures or completion treatment, there were three (2.7%) recurrences and two (1.8%) deaths in 112 women. Covens et al 11 also compared a group of women who had trachelectomy with another group of women who had radical hysterectomy and found no difference in disease-free survival. On that evidence, 11 we do not advocate hysterectomy following completion of a family.…”

Section: Discussionmentioning

confidence: 99%

“…Covens et al 11 also compared a group of women who had trachelectomy with another group of women who had radical hysterectomy and found no difference in disease-free survival. On that evidence, 11 we do not advocate hysterectomy following completion of a family. In the current series, one woman had a recurrence 7 years following surgery and after completion of her family.…”

Section: Discussionmentioning

confidence: 99%

“…2 Early reports suggested that radical trachelectomy is as efficacious for the treatment of early cervical cancer and maintains the potential for preservation of fertility. [3][4][5][6][7][8][9][10][11] Some authors have now published extended series that support the original data. [12][13][14][15][16] Pregnancies in most series are expressed as total numbers and do not take into account the women using contraception or not trying to conceive.…”

Section: Introductionmentioning

confidence: 99%

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Radical vaginal trachelectomy as a fertility‐sparing procedure in women with early‐stage cervical cancer—cumulative pregnancy rate in a series of 123 women

Shepherd

Spencer

Herod

et al. 2006

BJOG

200

126

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Objective To analyse the fertility rates, complications and recurrences in a group of women who have undergone radical vaginal trachelectomy and pelvic lymphadenectomy for early-stage cervical cancer.Design An observational series.Setting A Gynaecological Oncology Centre.Population One hundred and twenty-three consecutive women who underwent radical vaginal trachelectomy and pelvic lymphadenectomy for early-stage cervical cancer.Methods Data were collected prospectively.Main outcome measures Complications, recurrences, pregnancies and live births are presented as percentages of the total population. Fertility is presented as a 5-year cumulative rate, with women attempting to conceive as the denominator.Results A total of 123 women were followed up for an average of 45 months. Eleven (8.9%) had completion treatment (two radical hysterectomies and nine chemoradiotherapy) at the time of initial treatment. There were three recurrences (2.7%) among the women who did not have completion treatment and two (18.2%) in those who did. There were 6 perioperative and 26 postoperative complications. Sixty-three women attempted pregnancy. There were 55 pregnancies in 26 women and 28 live births in 19. Three women had continuing pregnancies. The 5-year cumulative pregnancy rate among women trying to conceive was 52.8%. All but two women were delivered by classical caesarean section and seven (25.0%) babies were born at 31 + 6 weeks or less.Conclusions For selected women with early-stage cervical cancer, radical vaginal trachelectomy and pelvic lymphadenectomy are fertility-sparing options, with a low incidence of recurrence and acceptable cumulative conception rates. Complications are few, although there is a high premature labour and miscarriage rate among pregnant women.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Radical vaginal trachelectomy as a fertility‐sparing procedure in women with early‐stage cervical cancer—cumulative pregnancy rate in a series of 123 women

Shepherd

Spencer

Herod

et al. 2006

BJOG

200

126

View full text Add to dashboard Cite

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“…In contrast to the data of other groups, we evaluated the cohort of women post RVT prospectively. It seems that adenocarcinomas have a higher rate of recurrence but so far it has not been possible to prove this with statistical significance (13). In this study, the five-year survival rate without recurrence following RVT is 95% and for radical hysterectomy 100%, if the cervix carcinoma was FIGO stage IB1.…”

Section: Rvtmentioning

confidence: 56%

“…A number of retrospective studies (12,13) show that the rates of recurrence and survival after RVT are similar or even superior to those following radical hysterectomy (14)(15)(16)(17)(18)(19). Radical removal of the cervix should be discussed with patients as a possible alternative therapy if preserving fertility is desirable.…”

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confidence: 99%