Oncological and Reproductive Outcomes of Abdominal Radical Trachelectomy

Abstract

Background/Aim: There is an increasing demand for preserving the fertility of young women impacted with early-stage cervical cancer. The aim of this study is to evaluate the oncological and reproductive outcomes of abdominal radical trachelectomy (ART). Patients and Methods: We retrospectively reviewed patients with FIGO stageIA2-IB1 cervical cancer who underwent ART from 2007 to 2018. We also compared the oncological prognosis between the patients who underwent ART and radical hysterectomy (RH). Results: A total of 42 patients underwent ART. During median follow-up 62.5 months, there were 4 (9.5%) recurrences and 1 (2.4%) death. As for tumors ≤2 cm, the 5-year recurrence-free survival (RFS) rate and overall survival (OS) rate for patients who underwent ART was similar to those who underwent RH (89.8% vs. 92.7%, p=0.42 and 97.3% vs. 95.0%, p=0.44, respectively). Nineteen patients attempted to conceive and seven of them were successful. There was one case of a first-trimester miscarriage, two cases of preterm delivery, three cases of full-term delivery and one ongoing pregnancy. Conclusion: ART could be a feasible alternative to RH for patients with tumors ≤2 cm with comparable oncological outcome.

Revolutionizing Early-Stage Cervical Cancer Treatment: A Comprehensive Review of Radical Trachelectomy as a Minimally Invasive Approach

“…The extensive International Radical Trachelectomy Assessment Study corroborated these findings, reporting no discernible difference in recurrence rates at 4.5 years between open and minimally invasive surgery [ 21 ]. A study delving into the oncological and reproductive feasibility of abdominal radical trachelectomy further supported the credibility of this approach, reporting recurrence rates of less than 6% and mortality rates of less than 3% [ 22 ]. Comparisons between radical trachelectomy and other established surgical methods, such as radical abdominal or radical vaginal hysterectomy, have consistently indicated similar morbidity and recurrence rates, validating radical trachelectomy as a viable and effective treatment option for early-stage cervical cancer [ 19 ].…”

Outcomes of Trachelectomy vs. Hysterectomy for Early-Stage Cervical Cancer: A Systematic Review and Meta-Analysis

“…Of the remaining 68 citations, 47 were omitted after reading the abstract. The remaining 21 articles were reviewed in detail and finally, 12 articles were included in the meta-analysis (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). Supplementary Table 3 presents the details of the included studies.…”

An update of oncologic and obstetric outcomes of radical trachelectomy for early‐stage cervical cancer: The need for further minimally invasive treatment

“…This procedure involves the removal of only the cervix, the surrounding tissues, and the upper part of the vagina; the uterus and ovaries are preserved. This procedure has several advantages and disadvantages: oncologic outcomes have been reported to be no worse than those of radical hysterectomy, 2,3 and increased numbers of pregnancies and births after treatment have been reported [4][5][6] ; however, a main concern is the risk of cancer recurrence, [7][8][9] and although the uterus is preserved, the risks of infertility and pregnancy complications such as premature labor, miscarriage, and low birth weight may be increased. [10][11][12][13] Moreover, patients who undergo RT require long-term follow-up to monitor for recurrence and to prevent complications related to the procedure.…”