ArticleGynecologic oncology2020
Fertility-sparing trachelectomy for early-stage cervical cancer: A proposal of an ideal candidate.
Article in Gynecologic oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 38 citations in OpenAlex.
- Diagnostic accuracy of intraoperative frozen section at radical abdominal trachelectomy for early-stage cervical cancer.Journal of gynecologic oncology · 2026Article
- Fertility Preservation Strategies in Female Cancer Patients: Current Approaches and Future Directions.Medicina (Kaunas, Lithuania) · 2025Review
- Long-Term Outcomes of Local Tumor Destruction/Excision Versus Total Hysterectomy for Stage IA Cervical cancer: A Retrospective Study Based on the SEER Database.International journal of women's health · 2025Article
- Radical vaginal trachelectomy: long-term oncologic and fertility outcomes in patients with early cervical cancer.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2024Article
- Fertility Preservation in Cervical Cancer-Treatment Strategies and Indications.Current oncology (Toronto, Ont.) · 2024Review
- Adoption strategies of fertility-sparing surgery for early-stage cervical cancer patients based on clinicopathological characteristics: a large retrospective cohort study.Frontiers in surgery · 2024Article
- Application of the Joint Frailty Copula Model for Analyzing Time to Relapse and Time to Death of Women with Cervical Cancer.International journal of women's health · 2023Article
- Fertility-Sparing and Less Radical Surgery for Cervical Cancer.Current oncology reports · 2022Review
- Cervical Cancer and Fertility-Sparing Treatment.Journal of clinical medicine · 2021Review
- Review
- Evaluation of adjuvant chemotherapy after abdominal trachelectomy for cervical cancer: a single-institution experience.International journal of clinical oncology · 2021Article
- Clinical Features and Prognostic Factors of Cervical Clear Cell Adenocarcinoma: A Retrospective Analysis of 74 Cases from a Tertiary Hospital.Technology in cancer research & treatmentArticle
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Authors and funding
15 authors at 12 institutions in 2 countries.
Funding
Abstract
objectiveTo propose an ideal patient candidate with early-stage cervical cancer for undergoing fertility-sparing trachelectomy.
methodsThis nationwide, multicenter, retrospective study was conducted by the Japan Society of Obstetrics and Gynecology involving women aged <45 years with clinical stage I-II cervical cancer who had planned fertility-sparing trachelectomy and pelvic lymphadenectomy between 2009 and 2013 (n = 393). Ideal candidates were defined to have a tumor size of ≤2 cm, no lymph node metastasis, no deep stromal invasion, and no high-risk histology (n = 284, 69.6%). Less-ideal candidates were defined to have any one of these four characteristics (n = 109, 30.4%). Propensity score inverse probability of treatment weighting was used to assess survival outcomes.
resultsLess-ideal candidates were more likely to undergo hysterectomy conversion (22.9% versus 3.2%), receive postoperative radiotherapy (11.9% versus 0.4%), or chemotherapy (32.1% versus 3.2%) compared with ideal candidates (all, P < 0.05). The weighted model revealed that among those who underwent trachelectomy (ideal candidates, n = 275 and less-ideal candidates, n = 84), less-ideal candidates had significantly decreased disease-free survival (5-year rates: 85.5% versus 95.5%; HR 3.93, 95% CI 1.99-7.74; P < 0.001) and cause-specific survival (92.5% versus 98.6%; HR 5.47, 95% CI 1.68-17.8, P = 0.001) compared with ideal candidates. Similarly, less-ideal candidates were significantly associated with decreased disease-free survival compared with ideal candidates among those who were young age, had small tumors or squamous histology, and underwent surgery alone (all, P < 0.05).
conclusionLess-ideal candidates had approximately four-fold higher recurrence risk and cancer mortality compared with ideal candidates. Ideal candidates for fertility-sparing trachelectomy for early-stage cervical cancer proposed in our study may be useful as the future framework for developing guidelines for fertility-sparing trachelectomy in Japan.
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