Introduction/Background Radical vaginal trachelectomy (RVT) is a safe and viable treatment option for patients with early stage cervical cancer wishing to preserve fertility. We performed a retrospective monocentric study to describe the detection rate of sentinel biopsy, frequency of residual tumor in trachelectomy specimen and the impact of changes in FIGO staging.

Methodology 107 patients who underwent RVT at University Hospital Jena (1998–2020) were included. Inclusion criteria: 21 to 41 years, cervical cancer stage Ia1 to Ib2, any tumor size, regardless of neoadjuvant chemotherapy, regardless of histotype. Exclusion criteria: radical hysterectomy in the first 6 months post trachelectomy.

Results In 85 cases, a previous conization was performed. Sentinel biopsy followed by systematic lymphadenectomy was documented for 80 patients. Bilateral detection rate: 80% (64/80), unilateral detection rate: 91% (73/80). N1 in 4.6% (5/107), all detected by sentinel biopsy and frozen section.

Residual tumor was found in trachelectomy specimen in 13 cases (15%) after conization. Parametrium was in all cases free from disease. In one case vaginal involvement was described.

For 67 cases the depth of invasion and tumor size were documented. For these cases the FIGO Stage was compared considering the classification in 2009 and 2018. 51% had the same staging, 31% were downgraded to stage 1a1 or 1a2 from 1b1 and 18% were upgraded to stage 1b2 from 1b1 due to tumor size >2 cm.

Conclusion Sentinel detection rate after conization was high. In a considerable proportion of patients, residual tumor was found in trachelectomy specimen. However, Parametrium was free of disease in all trachelectomy specimens, putting necessity of the radical approach into question. According to FIGO 2018 classification, FST would not have been indicated for some of the patients.

Disclosures No conflict of interest for main author and co-authors.