RT Journal Article SR Electronic T1 Abdominal Radical Trachelectomy in Fertility-Sparing Treatment of Early-Stage Cervical Cancer JF International Journal of Gynecologic Cancer JO Int J Gynecol Cancer FD BMJ Publishing Group Ltd SP 1407-1411 OP 1407-1411 DO 10.1111/IGC.0b013e3181b9549a VO 19 IS 8 A1 David Cibula A1 Jiri SlÁMa A1 Jiri SvÁRovskÝ A1 Daniela Fischerova A1 Pavel Freitag A1 Michal ZikÁN A1 Iva PinkavovÁ A1 David Pavlista A1 Pavel Dundr A1 Martin Hill YR 2009 UL http://ijgc.bmj.com/content/19/8/1407-1411.abstract 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.