ArticleInternational journal of gynecological cancer : official journal of the International Gynecological Cancer Society2024
Radical vaginal trachelectomy: long-term oncologic and fertility outcomes in patients with early cervical cancer.
Article in International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed.
- First European live birth following uterine and adnexal transposition for fertility preservation: a case report and overview of reported neonatal outcomes.F&S reports · 2026Article
- Review
- Prognostic value of circ_0000043/miR-590-5p in cervical cancer and regulation of tumor progression.Discover oncology · 2025Article
- A long-term retrospective analysis of oncologic and fertility outcomes in cervical cancer patients undergoing radical trachelectomy.Frontiers in oncology · 2025Article
- Modified abdominal radical trachelectomy used to spare fertility during surgery for early-stage cervical cancer: a case report.Journal of medical case reports · 2024Article
- Oncofertility and Fertility Preservation for Women with Gynecological Malignancies: Where Do We Stand Today?Biomolecules · 2024Review
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18 authors.
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Abstract
objectiveRadical vaginal trachelectomy is a fertility-preserving treatment for patients with early cervical cancer. Despite encouraging oncologic and fertility outcomes, large studies on radical vaginal trachelectomy are lacking.
methodDemographic, histological, fertility, and follow-up data of consecutive patients who underwent radical vaginal trachelectomy between March 1995 and August 2021 were prospectively recorded and retrospectively analyzed.
resultsA total of 471 patients of median age 33 years (range 21-44) were included. 83% (n=390) were nulliparous women. Indications were International Federation of Gynecology and Oncology (FIGO, 2009) stages IA1 with lymphvascular space involvement (LVSI) in 43 (9%) patients, IA1 multifocal in 8 (2%), IA2 in 92 (20%), IB1 in 321 (68%), and IB2/IIA in 7 (1%) patients, respectively. LVSI was detected in 31% (n=146). Lymph node staging was performed in 151 patients (32%) by the sentinel node technique with a median of 7 (range 2-14) lymph nodes and in 320 (68%) by systematic lymphadenectomy with a median of 19 (range 10-59) lymph nodes harvested. Residual tumor was histologically confirmed in 29% (n=136). In total, 270 patients (62%) were seeking pregnancy of which 196 (73%) succeeded. There were 205 live births with a median fetal weight of 2345 g (range 680-4010 g). Pre-term delivery occurred in 94 pregnancies (46%). After a median follow-up of 159 months (range 2-312), recurrences were detected in 16 patients (3.4%) of which 43% occurred later than 5 years after radical vaginal trachelectomy. Ten patients (2.1%) died of disease (five more than 5 years after radical vaginal trachelectomy). Overall survival, disease-free survival, and cancer-specific survival were 97.5%, 96.2%, and 97.9%, respectively.
conclusionOur study confirms oncologic safety of radical vaginal trachelectomy associated with a high chance for childbearing. High rate of pre-term delivery may be due to cervical volume loss. Our long-term oncologic data can serve as a benchmark for future modifications of fertility-sparing surgery.
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