Fertility‐sparing laparoscopic radical trachelectomy for young women with early stage cervical cancer
84
Citation
44
Reference
10
Related Paper
Citation Trend
Abstract:
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.Keywords:
Trachelectomy
Trachelectomy
Cite
Citations (1)
Cervical cancer is the third most common female cancer worldwide and the use of routine screening resulted in earlier stage and younger age at diagnosis. Fertility preservation via radical trachelectomy comes up as an option in such patients. Recent literature reviews confirm the safety of this operation with excellent oncologic outcomes in appropriately chosen patients. However, recurrent disease is likely and a strict follow-up is recommended to detect recurrences at an early stage following radical trachelectomy. In this report, a case who underwent radical trachelectomy and developed widespread recurrences 7 years after initial surgery possibly due to the lack of oncologic follow-up is discussed.
Trachelectomy
Radical surgery
Cite
Citations (3)
In recent years,the incidence of cervical cancer has the trend to ascend,with the age of patients getting younger.The young patients with cervical cancer need to preserve their fertility sparing.With the development of the new surgery and Laparoscopic,radical trachelectomy surgery,radical trachelectomy surgery as a new method of the treatment of early cervical cancer,restrictedly controls its surgical indications,and in combination with medical ethics and principles of evidence-based medicine,radical trachelectomy surgery not only achieves a radical cure of cervical cancer,but also fully takes into consideration the fertility sparing of the young patients with cervical cancer.Therefore,cervical radical trachelectomy is a feasible,effective and reasonable surgery.
Trachelectomy
Radical surgery
Cite
Citations (0)
Trachelectomy
Cite
Citations (56)
For all patients affected by a disease that could impair fertility before or during the reproductive lifespan, strategies to preserve their fertility and the ability to bear their own children is likely to be of utmost importance. While fertility preservation is a promising option, most of the technologies currently used are far from being well-established or are still experimental. Patients should be aware that no method guarantees success. Psychological and ethical impacts of fertility preservation are major concerns and should be included in the multidisciplinary approach to the patients.
Cite
Citations (4)
Trachelectomy
Cite
Citations (1)
The popularization of cervical cytological test significantly reduced the incidence of cervical cancer.However,cervical cancer is still the leading cause of death of the global gynecological cancer patients and the age of the patients is getting younger and younger.The young patients with early-stage cervical cancer can be treated with radical trachelectomy and bilateral pelvic lymph node dissection by vaginal,abdominal or laparoscopic methods,to preserve their fertility,which has been reported at home and abroad.By reviewing the related literature,this article gives us a brief summary of the indications,surgical progress and the pregnancy after the radical surgery of cervix.
Trachelectomy
Cite
Citations (0)
Cervical cancer is world-wide the second most frequent cancer found in women and represents 12% of all female malignancies. In fact, it is the most common female cancer in developing countries. There is now sufficient evidence to recommend that women with locally advanced cervical cancer confined to the pelvis receive concurrent pelvic radiation and chemotherapy. New surgical techniques such as laparoscopically assisted radical vaginal hysterectomy and trachelectomy (a fertility-preserving radical operation technique) are being established and have to be evaluated for their long-term safety. Causal treatment by developing multivalent antiviral drugs and vaccines is no longer a pure theoretical approach. Despite these improvements, the early diagnosis by colposcopy and gynaecological cytology remains the safest method to ensure early treatment avoiding death of cervical cancer.
Trachelectomy
Vaginal cancer
Gynecologic cancer
Cite
Citations (5)
Trachelectomy
Cite
Citations (0)
Trachelectomy
Lymphadenectomy
Cite
Citations (0)