Article Text

Download PDFPDF

22 Open vs. minimally invasive radical trachelectomy in early stage cervical cancer: international multicenter irta study results
  1. G Salvo1,
  2. PT Ramirez1,
  3. X Wu2,
  4. M Leitao3,
  5. BJ Mosgaard4,
  6. H Falconer5,
  7. M Perrotta6,
  8. G Rendón7,
  9. A Kucukmetin8,
  10. I Berlev9,
  11. J Persson10,
  12. M Vieira11,
  13. D Cibula12,
  14. C Fotopoulou13,
  15. K Liu14,
  16. R Ribeiro15,
  17. ME Capilna16,
  18. D Kaidarova17,
  19. G Baiocchi18,
  20. X Li2,
  21. J Li2,
  22. S Pedra-Nobre3,
  23. K Pálsdóttir5,
  24. F Noll6,
  25. S Rundle19,
  26. E Ulrikh9,
  27. R Kocian12,
  28. S Saso13,
  29. Z Hu14,
  30. A Tsunoda20,
  31. M Gheorghe21,
  32. R Bolatbekova17,
  33. B Pitcher22 and
  34. R Pareja23
  1. 1University of Texas MD Anderson Cancer Center, Department of Gynecologic Oncology and Reproductive Medicine, Houston, USA
  2. 2Fudan University Shanghai Cancer Center, Gynecologic Oncology, Shanghai, China
  3. 3Memorial Sloan-Kettering Cancer Center, Department of Surgery, New York, USA
  4. 4Univ. Hospital Copenhagen- Rigshospitalet, Gynecological, Copenhagen, Denmark
  5. 5Karolinska Institutet, Women’s and Children’s Health, Stockholm, Sweden
  6. 6Hospital Italiano de Buenos Aires, Ginecologia, Buenos Aires, Argentina
  7. 7Instituto de Cancerología – Las Américas, Ginecología Oncológica, Medellín, Colombia
  8. 8Queen Elizabeth Hospital, Northern Gynaecological Oncology Centre, Gateshead, UK
  9. 9N.N.Petrov National Medical Research Center of Oncology, Oncogynaecological, Saint-Petersburg, Russia
  10. 10Skane University Hospital- LUND, Department of Obstetrics and Gynecology, Lund, Sweden
  11. 11Barretos Cancer Hospital, Gynecologic Oncology, Barretos – SP, Brazil
  12. 12First Faculty of Medicine- Charles University, Gynecologic Oncology Center- Department of Obstetrics and Gynecology- General University Hospital, Prague, Czech Republic
  13. 13Imperial College London, Gynecologic Oncology, London, UK
  14. 14Renji Hospital- School of Medicine- Shanghai Jiaotong University, Department of Gynecologic Oncology, Shanghai, China
  15. 15Hospital Erasto Gaertner, Department Gynecologic Oncology, Curitiba, Brazil
  16. 16University of Medicine- Pharmacy-Science and Technology of Targu Mures, Department First Obstetrics and Gynecology Clinic, Targu Mures, Romania
  17. 17Kazakh Institute of Oncology and Radiology, Oncogynecology, Almaty, Kazakhstan
  18. 18AC Camargo Cancer Center, Gynecologic Oncology, Sao Paulo, Brazil
  19. 19Northern Gynaecological Oncology Centre, Gynaecological Oncology, Gateshead, UK
  20. 20Hospital Erasto Gaertner/Universidade Positivo, Gynecologic Oncology, Curitiba, Brazil
  21. 21Clinical County Emergency Hospital Targu Mures, First Obstetrics and Gynecology Clinic, Targu Mures, Romania
  22. 22University of Texas MD Anderson Cancer Center, Department of Biostatistics, Houston, USA
  23. 23Clinica Astorga- INC- HGM- UPB, Gynecologic Oncology, Medellín, Colombia


Objectives To compare disease-free survival (DFS) between patients who underwent open (ORT) versus minimally invasive (MIS) radical trachelectomy (RT) [laparoscopic (LRT) or robotic (RRT)].

Eligibility criteria included 1) RT and pelvic lymphadenectomy with/without sentinel lymph node mapping, 2) 1/2005 to 12/2017 3) squamous, adenocarcinoma, or adenosquamous histology, 4) stage IA2-IB1, 5) tumors ≤2 cm, 6) 15 or more cases per center.

Results A total of 698 patients [open (n=388) vs. MIS (310)] were included. The median follow-up time was 40.9 months (range, 1–179.1) [MIS 38.6 (range, <1–128.1) vs. open 68.3 (range, <1–200.8) (p<0.001)]. MIS patients had smaller tumors (no visible lesion: 76.8% vs 57.0%, < 1 cm: 1.9% vs. 2.8%, 1–2 cm: 21.3% vs. 40.2%, p<0.001) and lower rates of residual disease (42.9% vs. 56.2% p<0.001). (table 1) There were no differences in rates of parametrial involvement (2.1% vs. 1.3% p=0.055), vaginal involvement (0.8% vs. 1.4% p=0.198), positive margins (2.9% vs. 3.5% p=0.766), or positive nodes (7.2% vs. 4.5%, p=4.02). (table 2) Patients who underwent open RT had longer hospital stay (6 (1–23) vs 2 (0–24) days, p<0.001) and received more adjuvant therapy (12.7% vs. 5.9%, p=0.003). MIS patients had more readmissions (11.0% vs. 1.8%, p<0.001) and reoperations (4.8% vs. 1.5%, p=0.01). There was no difference in recurrence rate (6.4% vs. 5.7%, p=0.7492), DFS (p=0.46) or OS (p=0.91) between MIS and open surgical approaches (figure 1).

Abstract 22 Table 1

Patient characteristics

Abstract 22 Table 2

Tumor pathology and adjuvant treatment

Abstract 22 Figure 1

Kaplan-Meier plot of disease-free survival with number at risk

Abstract 22 Figure 2

Kaplan-Meier curve of overall survival

Conclusions Surgical approach in radical trachelectomy for low-risk cervical cancer was not associated with differences in recurrence rates or survival. MIS had worse perioperative outcomes.

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.