Vol 86, No 8 (2015)
ARTICLES
Conization and radical vaginal trachelectomy with laparoscopic lymphadenectomy in fertility-sparing surgical treatment of cervical cancer
DOI: 10.17772/gp/58986
Ginekol Pol 2015;86(8).
Abstract
Introduction: In the mid-80’s and 90’s of the last century, uterine-sparing surgical treatment methods were
proposed to women wishing to preserve their fertility.
Objectives: The aim of the study was to assess practical application of conization or radical vaginal trachelectomy
with laparoscopic lymphadenectomy in women with squamous cell cervical cancer (FIGO stages IA and IB1) who
want to retain their ability to procreate.
Material and methods: A total of 119 women (aged 25-43 years) were included in the study. Ninety-six women
(60 - IA1 and 36 - IA2) were deemed eligible for conization and 23 women with stages IA2 and IB1 with neoplastic
changes of <2cm in diameter were qualified for radical vaginal trachelectomy with laparoscopic lymphadenectomy.
Results: Conization was not radical in 9 cases and these women were reoperated. A 5-year follow-up in patients
after conization revealed disease recurrence (CIN) in 3 IA1 cases (6.5%), and 2 IA2 cases (9.1%). In patients with
follow-up of <5 years, no recurrence was observed in 9 out of 10 IA1 cases. Similarly, there was no recurrence in 7
out of 9 IA2 cases. A 5-year follow-up in patients after trachelectomy confirmed disease recurrence (CIN) in 1 IA2
case (6.25%). There was no disease recurrence in 2 IA1 cases and 4 IB1 cases. Out of 8 subjects staged IA2 with
a follow-up of <5 years, no disease recurrence was observed in 7 (87.5%) patients. During the same follow-up time,
no disease recurrence was detected in 3 patients staged IB1.
Conclusions: Proper uterine-sparing treatment with appropriate qualification guarantees adequate control of the
treatment process in women with cervical cancer stages IA and IB1 (<2 cm in diameter) according to FIGO.
Keywords: cervical cancer / conization / trachelectomy / fertility preservation /
