Article Text

Download PDFPDF

Radical Vaginal Trachelectomy After Laparoscopic Staging and Neoadjuvant Chemotherapy in Women With Early-Stage Cervical Cancer Over 2 cm: Oncologic, Fertility, and Neonatal Outcome in a Series of 20 Patients
  1. Malgorzata Lanowska, MD*,
  2. Mandy Mangler, MD*,
  3. Dorothee Speiser, MD*,
  4. Caroline Bockholdt, cand med*,
  5. Achim Schneider, MD*,
  6. Christhardt Köhler, MD*,
  7. Jekaterina Vasiljeva, MD*,
  8. Malak Al-Hakeem, MD*, and
  9. Giuseppe F. Vercellino, MD*
  1. *Department of Gynecology, Charité Universitätsmedizin, Berlin, Germany; and
  2. Department of Gynecology, King Saud University Medical College, Riyadh, Saudi Arabia.
  1. Address correspondence and reprint requests to Malgorzata Lanowska, MD, Charitė Universitätsmedizin Berlin, Campus Mitte and Benjamin Franklin, Department of Gynecology, Charitéplatz 1 D-10117, Berlin, Germany. E-mail: malgorzata.lanowska{at}


Objectives The aim of the study was to assess oncologic and fertility outcome of treatment in patients with cervical cancer of more than 2 cm seeking parenthood.

Methods The regimen consisted of laparoscopic lymphadenectomy as a staging procedure to confirm no lymph node metastases before neoadjuvant chemotherapy (NACT) consisting of 2 or 3 cycles of paclitaxel/ifosfamide/cisplatin followed by radical vaginal trachelectomy (RVT). Oncologic and fertility outcome was evaluated prospectively.

Results Twenty women were enrolled up to now. The mean age was 32 years (range, 26–41 years), and mean tumor size was 3 cm (range, 2.1–5.0 cm). Lymphadenectomy was performed before NACT without complications. During NACT, hematologic toxicity grade 3 was observed in 2 of 20 patients, and renal toxicity grade 3 in 1 of 20 patients. Radical vaginal trachelectomy was performed in 18 women until now with 2 intraoperative complications (ureter injury and injury of internal iliac vein). There were no severe postoperative or long-term complications. Complete pathologic remission was found in 9 of 18 patients. In 2 of 18 patients, chemoradiation was recommended because of insufficient pathologic response in the RVT specimen. After a mean follow-up of 23 months (range, 1–88 months), 1 relapse was observed. After RVT, 7 women tried to conceive until now. Seven pregnancies occurred in 5 women. Four children were born, 2 of whom were premature (31 weeks 2 days and 33 weeks 4 days of gestation); 1 pregnancy is ongoing.

Conclusions Laparoscopic lymphadenectomy followed by NACT and RVT in pN0 patients with cervical cancer of more than 2 cm seems to be an oncologically safe procedure with promising fertility outcomes.

  • Cervical cancer
  • Radical vaginal trachelectomy
  • Neoadjuvant chemotherapy
  • Fertility-sparing treatment
  • Fertility results

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • No funding was received for this work.

  • The authors declare no conflicts of interest.