Vaginal radical trachelectomy: an oncologically safe fertility-preserving surgery. An updated series of 72 cases and review of the literature

Plante, Marie; Renaud, Marie-Claude; Harel, François; Roy, Michel

doi:10.1016/j.ygyno.2004.05.032

Cited by 248 publications

(131 citation statements)

References 36 publications

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“…In this series, 62.6% of women had no residual disease on the final specimen. This is consistent with data from Plante et al 12 Covens et al 27 reported that the incidence of parametrial involvement in women with a tumour size of less than 20 mm and with a depth of invasion of less than 10 mm was 0.6%. However, in this series, there were two women who had completion treatment for parametrial involvement and a further woman who developed a parametrial recurrence.…”

Section: Discussionsupporting

confidence: 92%

“…This has led to one group to modify the technique of vaginal reconstruction to leave the raw area of the uterus from the excised cervix exposed. 12 It may be possible with some squamous lesions to try and conserve a portion of the upper cervix at the internal os if margins of excision can be guaranteed. This would probably help reduce the risk of prematurity.…”

Section: Discussionmentioning

confidence: 99%

“…[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. Many delay having children and others never attempt to become pregnant.…”

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

197

125

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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: Discussionsupporting

confidence: 92%

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

197

125

View full text Add to dashboard Cite

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“…Most data relating to RVT is collected retrospectively in specialized gynecological oncology treatment centers. The quality of the surgery and the experience of the surgeon are of great importance for the oncological results and the outcome of subsequent pregnancies (14,17,21,22). There are no randomized controlled trials regarding oncological outcomes of RVT compared with radical hysterectomy.…”

Section: Development Of Radical Trachelectomymentioning

confidence: 99%

“…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.…”

mentioning

confidence: 99%