open access

Vol 89, No 9 (2018)
Research paper
Published online: 2018-09-28
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Simple vaginal trachelectomy for early stage cervical cancer: A tertiary cancer center experience

Fuat Demirkiran, Ilker Kahramanoglu, Tugan Bese, Hasan Turan, Elif Meseci, Macit Arvas
DOI: 10.5603/GP.a2018.0081
·
Pubmed: 30318573
·
Ginekol Pol 2018;89(9):475-480.

open access

Vol 89, No 9 (2018)
ORIGINAL PAPERS Gynecology
Published online: 2018-09-28

Abstract

Objectives: Less radical fertility sparing procedures have been introduced to reduce morbidity and adverse obstetric outcome in cervical cancer. Our objective was to describe oncological and obstetric outcomes of women with early-stage cervical cancer who underwent a simple vaginal trachelectomy (SVT).

Material and methods: From 01/2013 to 05/2017, 14 women underwent SVT preceded by laparoscopic pelvic lymph node dissection.

Results: Patients’ median age was 32 years and all of them were nulliparous. Histology included squamous cell carcinoma and adenocarcinoma in 12 (85.7%) and 2 (14.3%) patients, respectively. Three patients had stage 1A1 with lymphovascular space invasion, 4 1A2 and 7 1B1. After obtaining final histopathology, one patient underwent radical hysterectomy due to positive surgical margin and excluded from analysis. None of the patients had lymph node metastasis. None of the 13 patients developed a recurrence within a median follow-up of 27 (6–56) months. Seven patients have conceived: 4 were term deliveries, 2 were late preterm deliveries and 1 was spontaneous abortion.

Conclusions: SVT in well selected early-stage cervical cancer patients seems to be a safe treatment option with excellent oncologic outcome, preserving reproductive function. Literature data will need to be confirmed in large prospective series.

Abstract

Objectives: Less radical fertility sparing procedures have been introduced to reduce morbidity and adverse obstetric outcome in cervical cancer. Our objective was to describe oncological and obstetric outcomes of women with early-stage cervical cancer who underwent a simple vaginal trachelectomy (SVT).

Material and methods: From 01/2013 to 05/2017, 14 women underwent SVT preceded by laparoscopic pelvic lymph node dissection.

Results: Patients’ median age was 32 years and all of them were nulliparous. Histology included squamous cell carcinoma and adenocarcinoma in 12 (85.7%) and 2 (14.3%) patients, respectively. Three patients had stage 1A1 with lymphovascular space invasion, 4 1A2 and 7 1B1. After obtaining final histopathology, one patient underwent radical hysterectomy due to positive surgical margin and excluded from analysis. None of the patients had lymph node metastasis. None of the 13 patients developed a recurrence within a median follow-up of 27 (6–56) months. Seven patients have conceived: 4 were term deliveries, 2 were late preterm deliveries and 1 was spontaneous abortion.

Conclusions: SVT in well selected early-stage cervical cancer patients seems to be a safe treatment option with excellent oncologic outcome, preserving reproductive function. Literature data will need to be confirmed in large prospective series.

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Keywords

cervical cancer, fertility-sparing, trachelectomy, lymphadenectomy

About this article
Title

Simple vaginal trachelectomy for early stage cervical cancer: A tertiary cancer center experience

Journal

Ginekologia Polska

Issue

Vol 89, No 9 (2018)

Article type

Research paper

Pages

475-480

Published online

2018-09-28

DOI

10.5603/GP.a2018.0081

Pubmed

30318573

Bibliographic record

Ginekol Pol 2018;89(9):475-480.

Keywords

cervical cancer
fertility-sparing
trachelectomy
lymphadenectomy

Authors

Fuat Demirkiran
Ilker Kahramanoglu
Tugan Bese
Hasan Turan
Elif Meseci
Macit Arvas

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