PT  - JOURNAL ARTICLE
AU  - David Cibula
AU  - Jiri SlÁMa
AU  - Jiri SvÁRovskÝ
AU  - Daniela Fischerova
AU  - Pavel Freitag
AU  - Michal ZikÁN
AU  - Iva PinkavovÁ
AU  - David Pavlista
AU  - Pavel Dundr
AU  - Martin Hill
TI  - Abdominal Radical Trachelectomy in Fertility-Sparing Treatment of Early-Stage Cervical Cancer
AID  - 10.1111/IGC.0b013e3181b9549a
DP  - 2009 Nov 01
TA  - International Journal of Gynecologic Cancer
PG  - 1407-1411--1407-1411
VI  - 19
IP  - 8
4099  - http://ijgc.bmj.com/content/19/8/1407-1411.short
4100  - http://ijgc.bmj.com/content/19/8/1407-1411.full
SO  - Int J Gynecol Cancer2009 Nov 01; 19
AB  - Background: Abdominal radical trachelectomy (ART) is one of the fertility-sparing procedures in women with early-stage cervical cancer. In comparison with vaginal radical trachelectomy, the published results of ART are so far limited.Methods: Enrolled were women referred for ART either by laparoscopy or laparotomy. The main inclusion criterion was stage IA2 or IB1 with a cranial extent that allows for preservation of at least 1 cm of the endocervical canal.Results: A total of 24 women were referred for the procedure, but fertility could not be preserved in 7 (29%) of them. Four women underwent immediate completion of radical hysterectomy because of a positive cranial surgical margin (n = 2) or sentinel node macrometastasis (n = 2) on frozen section. We found no correlation between tumor volume and inability to preserve fertility. A positive sentinel node was identified in 4 patients (17%); there were no false-negative results. Of the 9 women (53%) who have tried to conceive so far, 6 (67%) have conceived and 5 given birth, 2 of which were premature deliveries.Conclusions: Fertility cannot be preserved because of positive cranial margins or involved lymph nodes in almost one third of patients originally referred for radical trachelectomy. The main criterion for the selection of suitable patients should be the cranial extent of the tumor. Abdominal radical trachelectomy allows for achievement of satisfactory obstetrical outcomes.