Long-term outcomes after fertility-sparing laparoscopic radical trachelectomy in young women with early-stage cervical cancer: An Asan Gynecologic Cancer Group (AGCG) study

• Published in: Journal of surgical oncology Vol. 110; no. 3; pp. 252 - 257
• Main Authors: Park, Jeong-Yeol, Joo, Won Deok, Chang, Suk-Joon, Kim, Dae-Yeon, Kim, Jong-Hyeok, Kim, Yong-Man, Kim, Young-Tak, Nam, Joo-Hyun
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.09.2014; Wiley Subscription Services, Inc
• Subjects: Adult; Carcinoma - drug therapy; Carcinoma - mortality; Carcinoma - pathology; Carcinoma - surgery; Cervical cancer; Cervix Uteri - surgery; Chemotherapy, Adjuvant; early cervical cancer; Female; Fertility Preservation; Follow-Up Studies; Humans; laparoscopic radical trachelectomy; Laparoscopy; Live Birth; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Pregnancy; Pregnancy Rate; recurrence; risk factor; Risk Factors; Uterine Cervical Neoplasms - drug therapy; Uterine Cervical Neoplasms - mortality; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - surgery; Young Adult; recurrence; laparoscopic radical trachelectomy; early cervical cancer; risk factor
• ISSN: 0022-4790; 1096-9098; 1096-9098
• DOI: 10.1002/jso.23631

Objectives To evaluate the long‐term outcomes and risk factors for recurrence after fertility‐sparing laparoscopic radical trachelectomy (LRT) in young women with early‐stage cervical cancer. Methods Eighty‐eight consecutive patients from four tertiary cancer centers in Korea who had attempted fertility‐sparing LRT for early‐stage cervical cancer were included in this study. Results Seventy‐nine patients completed LRT. The mean age and tumor size were 31 years (range, 20–40 years) and 1.8 cm (range, 0.4–7 cm), respectively. Twenty‐nine patients had a tumor size greater than 2 cm, 22 had deep stromal invasion greater than 50%, and twelve had lymphovascular space invasion. After a median follow‐up time of 44 months (range, 3–105 months), nine patients had recurrence and one had died of disease. A tumor size greater than 2 cm (P = 0.039) and a depth of stromal invasion greater than 50% (P = 0.016) were significant risk factors for recurrence. Conclusions This is the largest series on fertility‐sparing LRT in young women with early cervical cancer. LRT is a feasible and safe fertility‐sparing alternative to radical hysterectomy in these women. A tumor size greater than 2 cm and a depth of stromal invasion greater than 50% were risk factors for recurrence. J. Surg. Oncol. 2014 110:252–257. © 2014 Wiley Periodicals, Inc.