Radical vaginal trachelectomy and pelvic lymphadenectomy for preservation of fertility in early cervical carcinoma

Burnett, Alexander; Roman, Lynda D.; OʼMeara, Anne T.; Morrow, C. Paul

doi:10.1016/s0090-8258(02)00142-7

Cited by 166 publications

(72 citation statements)

References 9 publications

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“…In an attempt 7 19 31 0 (0.0) 0 (0.0) Schlaerth et al 8 10 47 0 (0.0) 0 (0.0) Total 412 51 18 (4.4) 12 (2.9) to reduce this complication, the authors now place a urinary catheter through the isthmus as a stent and leave this in place for 3 days postoperatively. The complication rates are favourable when compared with those for radical vaginal or abdominal hysterectomy 17,22 and there have not been any long-term urinary or bowel problems as a result of trachelectomy in this series.…”

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: Introductionmentioning

confidence: 99%

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

show abstract

“…The risk of discovering micrometastasis in cases with a negative sentinel lymph node at standard staining (hematoxylin and eosin) can be up to 20 % when immunohistochemistry is added and 42.8 % at reevaluation with RT-PCR for the expression of CK19 [21,22]. Therefore, systemic pelvic lymphadenectomy regardless of sentinel lymph node involvement was considered necessary in all cases with early cervical cancer.…”

Section: Discussionmentioning

confidence: 99%

Radical Vaginal Trachelectomy with Laparoscopic Pelvic Lymphadenectomy for Fertility Preservation in Young Women with Early-Stage Cervical Cancer

Brătilă

Coroleucă³

2015

Indian J Surg

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The primary objective of this study was to describe our experience with the conservative treatment of early-stage cervical cancer (stages IA1, IA2, and IB1) with radical vaginal trachelectomy (RVT) and laparoscopic pelvic lymphadenectomy. This retrospective observational case series included 36 patients with early cervical cancer. Radical trachelectomy and laparoscopic pelvic lymphadenectomy were performed as described by D. Dargent in 32 of these cases. Oncologic, reproductive, and obstetric outcomes were observed subsequently over a median period of 42 (24-96) weeks. A total of 32 RVTs were preformed with a mean operating time of 117±22.8 (77-167) minutes and an average blood loss of 486 mL (150-800 mL). All obtained resection margins were negative for cancer. Lymphovascular space invasion was noted in 11 (30.55 %) of the cases. No recurrences occurred during the study period. Seven (17.8 %) patients were able to become pregnant postoperatively, five of whom delivered healthy infants near term. Radical vaginal trachelectomy with laparoscopic pelvic lymphadenectomy appears to be a safe therapeutic option for fertility preservation in young women with early cervical cancer.

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“…Marchiole (15) Plante (31) Shepherd (19) Hertel (14) Covens (13) Sonoda (20) Schlaerth (26) Dargent (28) Mathevet (39) Burnett (27) Lanowska ( treatment with radical hysterectomy in patients with a tumor diameter of ≤ 2cm and invasion of the connective tissue of less than 10 mm without invasion of the lymph nodes (Table 1) (14,17,18,(22)(23)(24)(25)(26)(27)(28). The recurrence rates are in the range of 2% to 5% and the mortality rates are 3% to 6% and are different in different groups.…”

Section: Rvtmentioning

confidence: 99%