Introduction/Background Botryoid rhabdomyosarcoma of the uterine cervix and cervical adenosarcoma are uncommon, but usually present with relatively better outcome. In the past, they were often treated with aggressive surgery and there were very few studies focused on fertility-sparing treatment. Here we reported our experience with cervical botryoid rhabdomyosarcoma/adenosarcoma, discussing proper selective criteria and type of fertility-sparing surgery for young patients with these two tumors.
Methodology We conducted a retrospective review of a prospectively maintained database of patients undergoing fertility-sparing surgery for cervical botryoid rhabdomyosarcoma or cervical adenosarcoma at our institution from 08/2006 to 08/2018
Results Eleven patients with cervical sarcoma (6 botryoid rhabdomyosarcoma and 5 adenosarcoma) were included in this study. Median age was 16.45 years (range, 11–25). One patient was offered cervical conization while others underwent abdominal radical trachelectomy. They all underwent adjuvant chemotherapy and presented with favorable outcomes at a median follow-up of 73.3 months (range, 30–151 months) except for one patient. This young lady with botryoid rhabdomyosarcoma had tumor recurred to her left kidney 5 years after her primary treatment. Although she underwent salvage treatment, tumor metastasized to her lumbar vertebra very soon and she died 6 months after the diagnosis of recurrence. However, there was no evidence of tumor involving her remaining uterus and adnexes.
Conclusion Although the very patient who died in our study had tumor metastasis to her kidney, we should understand that nearly 70% of treatment failure in patients with botryoid rhabdomyosarcoma and adenosarcoma was due to local recurrence. Our study showed that in properly selected cases of cervical sarcoma, abdominal radical trachelectomy appeared to secure local disease control and may be considered an alternative to hysterectomy.
Disclosure Nothing to disclose.
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