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  • Title: [Oncologic and fertility outcomes of young patients with early stage of cervical cancer treated by vaginal radical trachelectomy].
    Author: Cao D, Yang J, Xiang Y, Wu M, Pan L, Huang H, Lang J, Shen K.
    Journal: Zhonghua Fu Chan Ke Za Zhi; 2014 Apr; 49(4):249-53. PubMed ID: 24969330.
    Abstract:
    OBJECTIVE: To evaluate the prognosis and fertility outcomes of patients with early stage of cervical cancer treated by vaginal radical trachelectomy (VRT) in combination with laparoscopic pelvic lymphadenectomy. METHODS: The surgical data, disease recurrences and fertility outcomes were analyzed retrospectively for 51 patients who received VRT in Peking Union Medical College Hospital from Dec. 2003 to Nov. 2013. RESULTS: Forty-eight patients succeeded in preserving fertility. The median age was 29 years. International Federation of Gynecology and Obstetrics (FIGO) stage: 5 cases Ia1 with lymph vascular space invasion (LVSI), 4 cases Ia2 and 39 cases in stage Ib1. Tumor size: 20 cases with no visible lesion, 20 cases with tumor size ≤ 2 cm, 8 cases with tumor size > 2 cm. Histological type: 42 cases with squamous carcinoma, 6 cases with adenocarcinoma or adeno-squamous carcinoma. The mean excised cervical length and parametrial width was (2.6 ± 0.6) cm and (1.9 ± 0.5) cm, respectively. Six recurrences (12%) were observed after following up for a mean duration of (35 ± 21) months. The recurrent rate in patients with tumor size > 2 cm was 3/8, which was significantly higher than that of the patients with tumor size ≤ 2 cm (8%, 3/40;P < 0.01). Of the 35 patients who desired to conceive after the surgery, 13 women had 17 pregnancies and the pregnant rate was 37% (13/35). Nine women obtained 10 healthy live birth babies. The fertility rate was 26% (9/35). CONCLUSIONS: VRT in combination with laparoscopic pelvic lymphadenectomy could preserve the fertility of patients with early stage of cervical cancer with acceptable oncologic and fertility outcomes. Tumor size ≤ 2 cm should be emphasized as the indication of VRT in considering of the higher recurrent rate in patients with tumor size > 2 cm.
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