Introduction/Background Trachelectomy with pelvic lymphadenectomy is considered a viable surgical procedure for fertility preservation in patients with early stage cervical carcinoma. The purpose of this study was to analysis postprocedural follow-up of oncological and fertility outcomes at a single centre.
Methodology We conducted a retrospective analysis of women with early stage cervical carcinoma, treated at the University Medical Centre Ljubljana, between 2007 and 2017. The study group was compiled of 26 women, age 22 to 40 years old (mean 32,8 years old).
Results Out of 26 women with early stage cervical cancer, 25 women were treated with vaginal radical trachelectomy (VRT) and laparoscopic pelvic lymphadenectomy (LPL) and one with only VRT. Mean age and BMI were 32,8 years and 21,54 kg/m2; respectively. One patient was IA1, two IA2, twenty-two IB1 and one IB2. Histology subtypes included squamous cell carcinoma (n=16), adenocarcinoma (n=8), endometrioid adenocarcinoma (n=1) and clear cell carcinoma (n=1). No perioperative complications were documented, postoperative complications included urinary retention and anaemia. All were treated with conservative measures. Within the follow-up period (12 – 60 months) 3 women (12%) developed disease recurrence, all were treated with local excision and adjuvant chemoradiotherapy. One patient died 15 months after primary treatment, following progression of the disease. Two remaining patients are in remission. Of the 24 women who had neither additional surgical procedures, nor adjuvant therapy, we documented 14 attempted pregnancies. All women with successful pregnancies had a separate procedure; laparoscopic cerclage. Out of 14 pregnancies five ended in miscarriage, one pregnancy resulted in second trimester delivery (24/25. week) and eight resulted in third trimester delivery (34.-38. week). All births were performed with a Caesarean section.
Conclusion Cervical carcinoma effects women in reproductive age, limiting their chance for a successful pregnancy. Radical trachelectomy with SNL or pelvic lymphadenectomy should be an option for women that wish to preserve fertility. Good preoperative staging is essential in the process. Our data suggest that surgical approach is associated with low perioperative morbidity. Our recorded pregnancy rate is similar to that described in the literature.
Disclosures Authors have nothing to disclose.
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