EP296 Vaginal fertility-sparing surgery and laparoscopic sentinel lymph node detection in early cervical cancer. Oncological outcomes and long-term follow-up

2019 
Introduction/Background The aim of this study was to analyze the oncological outcomes and risk factors for recurrence of vaginal fertility-sparing surgery (FSS) and laparoscopic sentinel lymph node biopsy (SLNB) in patients with early cervical cancer (CC). Methodology From March 2005 to April 2018, 38 patients diagnosed with early stage CC underwent vaginal FFS at the Hospital Clinic, Barcelona, Spain. Patients with FIGO stage IA1 with lymphovascular space invasion (LVSI) and stage IA2 underwent simple trachelectomy and patients with stage IB1 underwent vaginal radical trachelectomy (VRT). All cases underwent laparoscopic SLNB. In the first cases, laparoscopic bilateral pelvic lymphadenectomy (LBPL) was completed immediately after SLNB. Clinical and oncological follow-up data were prospective collected. Results The median age at diagnosis was 33.5 years old (range 22–44). Simple trachelectomy was performed in seven cases (18.4%) and VRT in 31 (81.6%). Nineteen patients were treated with laparoscopic SLNB exclusively and 19 with SLNB plus LBPL. There were no significant differences between the two groups regarding histology and tumor size. The median follow-up was 73 months (range 1–160 months). There were 4 recurrences (3 patients with IB1 and one in IA2). Two occurred in the SLNB group and 2 in the SLNB plus LBPL group. All recurrences were diagnosed in patients with adenocarcinoma tumors and three without LVSI. Conclusion Vaginal FFS with laparoscopic SLNB seems to be a safe oncological procedure in early stage CC patients. Further studies are needed to clarify the role of adenocarcinoma histology as a prognostic factor of recurrence. Disclosure Nothing to disclose.
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