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Fertility-sparing laparoscopic radical trachelectomy for young women with early stage cervical cancer
Article first published online: 10 DEC 2009
DOI: 10.1111/j.1471-0528.2009.02446.x
© 2009 The Authors Journal compilation © RCOG 2009 BJOG An International Journal of Obstetrics and Gynaecology
Issue
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 117, Issue 3, pages 340–347, February 2010
Additional Information
How to Cite
Kim, J.-H., Park, J.-Y., Kim, D.-Y., Kim, Y.-M., Kim, Y.-T. and Nam, J.-H. (2010), Fertility-sparing laparoscopic radical trachelectomy for young women with early stage cervical cancer. BJOG: An International Journal of Obstetrics & Gynaecology, 117: 340–347. doi: 10.1111/j.1471-0528.2009.02446.x
Publication History
- Issue published online: 12 JAN 2010
- Article first published online: 10 DEC 2009
- Accepted 7 October 2009. Published Online 10 December 2009.
Keywords:
- Cervical cancer;
- fertility preservation;
- laparoscopic radical trachelectomy
Please cite this paper as: Kim J-H, Park J-Y, Kim D-Y, Kim Y-M, Kim Y-T, Nam J-H. Fertility-sparing laparoscopic radical trachelectomy for young women with early stage cervical cancer. BJOG 2010;117:340–347.
Objective To report the results of laparoscopic radical trachelectomy (LRT) with respect to surgical, oncological and reproductive outcomes.
Design Retrospective analysis.
Setting University of Ulsan College of Medicine, Asan Medical Centre, Seoul, Korea.
Sample Thirty-two consecutive patients who wish to preserve fertility with early stage cervical cancer.
Methods Demographic, clinicopathologic, surgical, and follow-up data were obtained from patients’ medical records. All patients agreed to telephone interviews to assess their menstrual and obstetrical outcomes.
Main outcome measures Surgical parameters, perioperative complication, disease-free survival, overall survival, return and pattern of menstruation and pregnancy rate.
Results Thirty-two consecutive patients who wish to preserve fertility with early stage cervical cancer were offered LRT. In five patients, the planned LRT procedures were abandoned during the operations because of lymph node metastasis or parametrial involvement on frozen section. The mean age was 29 years (range, 22–37 years). The mean tumour size was 1.7 cm in diameter (range, 0.4–3.5 cm). The mean operating time was 290 min (range, 120–520 min) and the mean estimated blood loss was 332 ml (range, 50–1000 ml). Perioperative transfusion was required in six patients. There were no perioperative complications requiring further management. After a median follow-up time of 31 months (range, 1–58 months), there was one recurrence and death from disease. Regular menstruation returned in 24 patients. Six patients attempted to conceive, and three succeeded.
Conclusions Laparoscopic radical trachelectomy may be a safe and useful alternative to radical hysterectomy for women with early cervical cancer who want to preserve their fertility.