Introduction/Background We investigated the long-term oncologic outcomes and prognostic factors in CC patients following laparoscopic radical trachelectomy (LRT) with vaginal colpotomy.
Methodology Between 2004 and 2018, 118 CC patients with FIGO stage IA2-IIA1 were treated with LRT with vaginal colpotomy in Asan medical center. The cases of prior neoadjuvant chemotherapy for CC or intraoperative converted radical hysterectomy were excluded. Total 101 patients were included in this study. Clinicopathological variables of the patients were retrospectively reviewed from electronic medical records.
Results The median follow-up period was 54.7 months (IQR, 24.7–77.7). The mean age and tumor size were 32.0 (range, 22–43) and 2.03cm (range, 0.1–7) and Stage IB1 disease was the most common (83.2%), followed by stage IA2 (10%) and IB2 (5.9%). Forty-seven (46.5%) patients had a tumor size greater than 2cm. Twelve patients (11.9%) had lympho-vascular space invasion (LVSI), 26 patients (25.7%) had deep stromal invasion greater than 50%, and 2 patients (2%) had vaginal involvement. Two patients (2.0%) had lymph node metastasis. Twelve (10.9%) had adjuvant chemotherapy after surgery. The 5-year overall survival (OS) rate was 98% and the 5-year disease-free survival (DFS) rate was 91.1%. A deep stromal invasion greater than 50% (P=0.025), tumor grade (P=0.027), vagina involvement (p=0.040), and LVSI (P=0.020) were significant prognostic factors for recurrence. In tumor size below 2 cm, the 5-year DFS was 94.4%. Moreover, in tumor size below 2cm with no risk factors, there was no recurrence.
Conclusion LRT with vaginal colpotomy is feasible and has favorable oncologic outcomes in tumor size below 2 cm with no risk factors. And in cases of having above recurrent risk factors, we may consider further adjuvant chemotherapy or warning to the patients about recurrence. However, further study is warranted.
Disclosure Nothing to disclose.
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