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Cervical Cancer
The Safety and Effectiveness of Abdominal Radical Trachelectomy for Early-Stage Cervical Cancer During Pregnancy
  1. Kosuke Yoshihara, MD, PhD*,
  2. Tatsuya Ishiguro, MD, PhD*,
  3. Makoto Chihara, MD*,
  4. Eiri Shima, MD*,
  5. Sosuke Adachi, MD, PhD*,
  6. Masanori Isobe, MD*,
  7. Kazufumi Haino, MD, PhD†,
  8. Masayuki Yamaguchi, MD, PhD*,
  9. Masayuki Sekine, MD, PhD*,
  10. Katsunori Kashima, MD, PhD*,‡,
  11. Koichi Takakuwa, MD, PhD†,
  12. Nobumichi Nishikawa, MD, PhD* and
  13. Takayuki Enomoto, MD, PhD*
  1. * Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan;
  2. † Department of Perinatology, Niigata University Medical and Dental Hospital, Niigata, Japan; and
  3. ‡ Department of Obstetrics and Gynecology, Uonuma Kikan Hospital, Minamiuonuma, Japan.
  1. Address correspondence and reprint requests to Takayuki Enomoto, MD, PhD, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata City 951-8510, Japan. E-mail: enomoto{at}med.niigata-u.ac.jp.

Abstract

Objectives Cervical cancer is one of the most frequently diagnosed cancers in pregnancy. Our aim was to evaluate the safety and efficacy of abdominal radical trachelectomy (ART) for pregnant women with early-stage cervical cancer who strongly desire to preserve their pregnancies.

Methods/Materials A retrospective observational study was performed for stage IB1 cervical cancer patients who underwent ART or radical hysterectomy (RH) at our hospital between February 2013 and June 2017. We compared differences in perioperative findings and oncologic outcomes among ART during pregnancy (ART-DP), ART, and RH groups.

Results A total of 38 patients were included in this analysis. Six, 10, and 22 patients were assigned to the ART-DP, ART, and RH groups, respectively. There were no significant differences in the distribution of pathological TNM classifications, histology, tumor size, stromal invasion, and lymph-vascular space invasion among the 3 groups. The patients in the ART-DP group were younger than those in the RH group (P = 0.014). The ART-DP group was associated with more blood loss and prolonged surgery compared with the RH group (P = 0.017 and P = 0.014). The number of total lymph nodes in the ART-DP group was lower than that in the RH group (P = 0.036). However, there were no significant differences in age, surgical time, blood loss, or lymph node count between the ART-DP and ART groups. There were no significant differences in progression-free and overall survival times among the 3 groups, and no recurrence was observed in the ART-DP group.

Conclusions Abdominal radical trachelectomy may be a tolerable treatment option for pregnant women with early-stage cervical cancer who strongly desire a baby.

  • Abdominal radical trachelectomy
  • Cervical cancer
  • Pregnancy

https://doi.org/10.1097/IGC.0000000000001218

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    Footnotes

    • The authors declare no conflicts of interest.