@article {Zusterzeel1293, author = {Petra L.M. Zusterzeel and Fraukje J.M. Pol and Maaike van Ham and Ronald P. Zweemer and Ruud L.M. Bekkers and Leon F.A.G. Massuger and Ren{\'e} H.M. Verheijen}, title = {Vaginal Radical Trachelectomy for Early-Stage Cervical Cancer: Increased Recurrence Risk for Adenocarcinoma}, volume = {26}, number = {7}, pages = {1293--1299}, year = {2016}, doi = {10.1097/IGC.0000000000000763}, publisher = {BMJ Specialist Journals}, abstract = {Objective To evaluate consecutive vaginal radical trachelectomies (VRTs) in early-stage cervical cancer in the 2 main referral centers for fertility-preserving surgery in the Netherlands.Materials and Methods Oncology, fertility, and obstetrical data were recorded in a regional database of all VRTs without neoadjuvant chemotherapy performed in 2 major referral centers between 2000 and 2015.Results Most of the patients (91.7\%) had stage IB1 disease. In 72.0\%, squamous cell carcinoma was the histologic diagnosis; in 24.2\%, adenocarcinoma; and in 3.8\%, adenosquamous carcinoma. The median follow-up was 51 months.Nine (6.8\%) recurrences occurred, 4 resulting in death of disease (death rate, 3.0\%). Recurrence rates were 12.5\% for adenocarcinoma, 20\% for adenosquamous carcinoma, and 4.2\% for squamous cell carcinoma (P \< 0.01).From 117 women, data about fertility and obstetrical outcome were obtained. Almost 60\% of women attempted to conceive after a VRT. Of these women, 40\% needed fertility treatment. A total of 47 pregnancies were established, and a total of 37 children were born of which 30 (81.1\%) were delivered after 32 weeks of gestational age.Conclusions Nonsquamous cell histology and high-grade disease are associated with a significantly higher risk of recurrence in the univariate and multivariate analyses. Women with both these histology features should be counseled reticently for VRT.Pregnancies after VRT must be regarded as high-risk pregnancies with a high prematurity rate.}, issn = {1048-891X}, URL = {https://ijgc.bmj.com/content/26/7/1293}, eprint = {https://ijgc.bmj.com/content/26/7/1293.full.pdf}, journal = {International Journal of Gynecologic Cancer} }