Oncological and obstetric outcomes after fertility-sparing radical abdominal trachelectomy for early stage cervical cancer: a tertiary centre's 10 years' experience. (17th February 2019)

• Record Type: Journal Article
• Authors: Ayhan, Ali; Tohma, Yusuf Aytac; Sahin, Hanifi; Kocaman, Eda; Tunc, Mehmet; Haberal, Asuman Nihan
• Is Part Of: Journal of obstetrics and gynaecology. Volume 39:Number 2(2019)
• Page Start: 248
• Page End: 252
• Publication Date: 2019-02-17
• Subjects: Fertility-sparing -- cervical cancer -- oncofertility -- abdominal trachelectomy; Obstetrics -- Periodicals; Gynecology -- Periodicals; 618.05
• DOI: 10.1080/01443615.2018.1498830
• Languages: English
• ISSNs: 0144-3615

Abstract

Abstract: The aim of this study is to present our clinical experience about fertility-sparing procedures in early stage cervical cancer and its obstetrical and oncological outcomes. Between the years 2006 and 2016, a total of 22 early stage cervical cancer patients who underwent a fertility-sparing radical abdominal trachelectomy in our clinic were retrospectively analysed. The median age was 33 (range: 28–39) years. The median follow-up was 47 (range: 22–125) months. Five patients (22.7%) had Stage IA1, three patients had (13.6%) Stage IA2, and 14 patients (63.6%) had Stage IB1 disease. Only one patient had a recurrence. A pregnancy was obtained in five patients (22.7%) and one of them (20%) had a live birth. A pregnancy was obtained spontaneously in two patients (40%), whereas assisted reproductive techniques were used in three of the patients (60%). A miscarriage occurred in two patients (40%), and one of them was within the first trimester and the other was within the second trimester. Impact statement: What is already known on the subject? Currently, the first-line treatment of early stage cervical cancer is surgery. However, a fertility-sparing trachelectomy is the most widely adopted approach in the reproductive aged patients who have a desire to be pregnant later. What does this study add? In the literature, there is a growing number of studies on this subject. However, it would take time to obtain adequate knowledge. We believe that our study would contribute to the existing data. What are the implication of these findings for clinical practice? This study is important as it indicates that a multidisciplinary approach is required to preserve fertility among gynaecologic oncologists and the outcomes would be reflected into the clinical practice. In addition, we believe that our study would pave the way for further studies regarding this subject among oncologists.