An update of oncologic and obstetric outcomes of radical trachelectomy for early-stage cervical cancer: The need for further minimally invasive treatment

J Obstet Gynaecol Res. 2024 Feb;50(2):175-181. doi: 10.1111/jog.15824. Epub 2023 Nov 6.

Abstract

Aims: To investigate the oncologic and obstetric outcomes of radical trachelectomy (RT) in patients with early-stage cervical cancer and to evaluate the potential role of fertility-preserving treatments in improving pregnancy outcomes while oncologic status is stable.

Methods: In this single-institution study, we analyzed the oncologic and obstetric outcomes of 67 patients with early-stage cervical cancer who underwent RT at Nagoya University Hospital.

Results: The cancer recurrence rate (6.0%) and the mortality rate (1.5%) were comparable with those of previous studies. Of the 46 patients who attempted to conceive after RT, 19 (41.3%) became pregnant, and 16 gave birth. Of these 37.5% delivered at term, and delivery at less than 28 weeks of gestation occurred in 31.3% of pregnancies.

Conclusions: RT is a viable treatment option for selected patients with early-stage cervical cancer. However, the use of less invasive techniques, such as conization/simple trachelectomy and pelvic lymph node dissection, may improve pregnancy outcomes while oncologic status is stable.

Keywords: cervical cancer; fertility-preserving surgery; oncologic outcome; trachelectomy.

MeSH terms

  • Female
  • Fertility Preservation* / methods
  • Humans
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Pregnancy
  • Retrospective Studies
  • Trachelectomy* / adverse effects
  • Uterine Cervical Neoplasms* / pathology