The oncological and obstetric results of radical trachelectomy as a fertility-sparing therapy in early-stage cervical cancer patients

• DOI: 10.1186/s12905-022-01990-w
• Publication Date: 2022-10-26T19:03:22Z
• Authors: Tao Chen; Jia Li; Yan Zhu; An-Wei Lu; Li Zhou; Jian-San Wang; Ying Zhang; Jun-Tao Wang
• Keywords: China; Research; Trachelectomy; Uterine Cervical Neoplasms; Gynecology and obstetrics; Neoadjuvant chemotherapy; Radical trachelectomy; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Pregnancy; Cervical cancer; RG1-991; Humans; Female; Public aspects of medicine; RA1-1270; Fertility preservation; Child; Retrospective Studies; Neoplasm Staging

Abstract Purpose This study explored the oncological and obstetric results of radical trachelectomy (RT) in early-stage cervical cancer patients.

Methods A retrospective analysis was conducted the oncological and obstetric results of 23 patients with early cervical cancer (stages IA2–IB3; International Federation of Gynecology and Obstetrics, 2018) who underwent RT in The Maternal and Child Health Care Hospital of Guiyang, China, from October 2004 to September 2018.

Results 23 patients had cervical tumors of the squamous cell carcinoma histological type. All 23 patients retained reproductive function. The mean follow-up time was 112.87 ± 55.75 (36–199) months. The median tumor size was 2.00 ± 1.35 cm (imperceptible to the eyes 5.00 cm). No recurrence was observed in any of the patient cases. Among the patients with a tumor size > 4 cm (up to 5 cm), three patients who wished to preserve fertility accepted RT following neoadjuvant chemotherapy The pregnancy outcomes were as follows: 8 cases (47.06%) out of 17 cases who attempting pregnancy conceived 12 times.First-trimester abortion and the voluntary abandonment of pregnancy occurred in 4 cases (33.33%), respectively, one patient performed deliberate termination at 24 weeks of gestation. Second-trimester abortion occurred in three cases (25.0%) for chorioamnionitis. Premature delivery at 32 weeks occurred in one case (8.33%).

Conclusion Radical trachelectomy is a safe and effective treatment for women with early-stage cervical cancer preserving fertility biology. Patients with a cervical tumor sized > 4 cm can be pregnant after neoadjuvant chemotherapy and RT. Accordingly, this treatment is worthy of further exploration.