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Fertility Outcome After Radical Vaginal Trachelectomy: A Prospective Study of 212 Patients
  1. Dorothee Speiser, MD*,
  2. Mandy Mangler, MD*,
  3. Christhardt Köhler, MD*,
  4. Kati Hasenbein, MD*,
  5. Hermann Hertel, MD,
  6. Vito Chiantera, MD*,
  7. Elisabeth Gottschalk, MD* and
  8. Malgorzata Lanowska, MD*
  1. * Department of Gynecology, Charité University Medicine, Berlin; and
  2. Department of Gynecology, Medical School Hannover, Hannover, Germany.
  1. Address correspondence and reprint requests to Malgorzata Lanowska, MD, Department of Gynecology, Charitė Universitätsmedizin Berlin, Campus Mitte and Benjamin Franklin, Charitéplatz 1 D-10117 Berlin, Germany. E-mail: malgorzata.lanowska{at}charite.de.

Abstract

Objective For treatment in patients with early-stage cervical cancer, radical vaginal trachelectomy (RVT) as a fertility-preserving surgery can be put on a par with radical hysterectomy as to oncologic safety. Our aim was to investigate the fertility concerns and outcome.

Methods Prospective collection of fertility data of patients treated with RVT. The data were collected on personal communication, by telephone, or e-mail correspondence. Descriptive statistical analysis was performed.

Results Between March 2005 and April 2010, 212 patients were followed up after RVT. Only 76 patients (35.9%) were seeking parenthood currently. Sixty pregnancies occurred in 50 women. Five patients (8.3%) had first-trimester miscarriage, 3 had second-trimester miscarriage (5.0%), 2 patients decided for pregnancy termination (3.3%), and 1 patient (1.7%) had an ectopic pregnancy. Three women (5.0%) delivered prematurely before 28th weeks of gestation, 15 (25.0%) delivered between 28 and 36 weeks, and 27 women (45.0%) reached full term. Four pregnancies are ongoing.

Conclusions Preservation of childbearing function is a great advantage for patients with early-stage cervical cancer. Many patients do not seek parenthood immediately. We see no impairment of fertility and have solid data on pregnancy outcome. Premature labor is the main problem in pregnancy after RVT.

  • Early-stage cervical cancer
  • Radical vaginal trachelectomy
  • Fertility-preserving treatment
  • Pregnancy after cervical cancer

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Footnotes

  • The authors declare no conflicts of interest.

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