Article Text
PDF
Abstract
Introduction/Background Radical trachelectomy (RT) combined with pelvic lymphadenectomy (PLND) has been used to treat early stage cervical cancer patients who wish to preserve their fertility. Currently there is no standard of fertility-sparing treatment for women with stage IB2-IIA1 cervical cancer. Neoadjuvant platinum based chemotherapy (NACT) is used to reduce the tumor size. The next stage is RT combined with PLND. But vaginal, abdominal, laparoscopic, and robotic approaches have been used during RT with pelvic PLND, all of these approaches cause peritoneal damage, which could result in periadnexal adhesion. The aim of the present study was to discuss a fertility-preserving option, NACT with the VRT with retroperitoneal PLND.
Methodology To reduce a tumor and minimize peritoneal damage, we introduce NACT with retroperitoneal PLND.Nine Ukrainian women with FIGO 2018 stage IB2 and IIA1 cervical cancers have received 3 to 4 cycles of chemotherapy according to TP regimen. VRT with retroperitoneal PLND was performed in all patients.
Results All patients have had response to chemotherapy. The complete resection of the disease was achieved without causing any intraoperative and severe postoperative complications. Four patients have had lymphocysts in the postoperative period. These patients were treated by the conservative methods. No adjuvant treatments were given, and the patients are currently free of disease.
Retroperitoneal PLND
Conclusion NACT for fertility sparing treatment is an innovative approach which is potentially quite interesting for many young women affected by cervical cancer with the tumor size >2 cm. And VRT with retroperitoneal PLND can be safely performed. Because peritoneal damages, which can cause periadnexal adhesion, could be avoided. We consider that this surgical approach and NACT may be a good treatment option for women with cervical cancer who wish to preserve their fertility.
Disclosures no potential conflict of interest to report