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Abdominal radical trachelectomy in fertility-sparing treatment of early-stage cervical cancer
D. Cibula, J. Sláma, J. Svárovský, D. Fischerová, P. Freitag, M. Zikán, I. Pinkavová, D. Pavlišta, P. Dundr, M. Hill
Jazyk angličtina Země Spojené státy americké
Typ dokumentu práce podpořená grantem
Grantová podpora
NS10037
MZ0
CEP - Centrální evidence projektů
Digitální knihovna NLK
Plný text - Část
Zdroj
NLK
ProQuest Central
od 2001-01-01 do Před 6 měsíci
Health & Medicine (ProQuest)
od 2001-01-01 do Před 6 měsíci
- MeSH
- adenokarcinom chirurgie patologie MeSH
- biopsie sentinelové lymfatické uzliny MeSH
- břicho chirurgie patologie MeSH
- dospělí MeSH
- fertilita MeSH
- gynekologické chirurgické výkony MeSH
- hysterektomie MeSH
- lidé MeSH
- lymfatické metastázy MeSH
- nádory děložního čípku chirurgie patologie MeSH
- následné studie MeSH
- prognóza MeSH
- spinocelulární karcinom chirurgie patologie MeSH
- staging nádorů MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
BACKGROUND: Abdominal radical trachelectomy (ART) is one of the fertility-sparing procedures in women with early-stage cervical cancer. In comparison with vaginal radical trachelectomy, the published results of ART are so far limited. METHODS: Enrolled were women referred for ART either by laparoscopy or laparotomy. The main inclusion criterion was stage IA2 or IB1 with a cranial extent that allows for preservation of at least 1 cm of the endocervical canal. RESULTS: A total of 24 women were referred for the procedure, but fertility could not be preserved in 7 (29%) of them. Four women underwent immediate completion of radical hysterectomy because of a positive cranial surgical margin (n = 2) or sentinel node macrometastasis (n = 2) on frozen section. We found no correlation between tumor volume and inability to preserve fertility. A positive sentinel node was identified in 4 patients (17%); there were no false-negative results. Of the 9 women (53%) who have tried to conceive so far, 6 (67%) have conceived and 5 given birth, 2 of which were premature deliveries. CONCLUSIONS: Fertility cannot be preserved because of positive cranial margins or involved lymph nodes in almost one third of patients originally referred for radical trachelectomy. The main criterion for the selection of suitable patients should be the cranial extent of the tumor. Abdominal radical trachelectomy allows for achievement of satisfactory obstetrical outcomes.
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- $a BACKGROUND: Abdominal radical trachelectomy (ART) is one of the fertility-sparing procedures in women with early-stage cervical cancer. In comparison with vaginal radical trachelectomy, the published results of ART are so far limited. METHODS: Enrolled were women referred for ART either by laparoscopy or laparotomy. The main inclusion criterion was stage IA2 or IB1 with a cranial extent that allows for preservation of at least 1 cm of the endocervical canal. RESULTS: A total of 24 women were referred for the procedure, but fertility could not be preserved in 7 (29%) of them. Four women underwent immediate completion of radical hysterectomy because of a positive cranial surgical margin (n = 2) or sentinel node macrometastasis (n = 2) on frozen section. We found no correlation between tumor volume and inability to preserve fertility. A positive sentinel node was identified in 4 patients (17%); there were no false-negative results. Of the 9 women (53%) who have tried to conceive so far, 6 (67%) have conceived and 5 given birth, 2 of which were premature deliveries. CONCLUSIONS: Fertility cannot be preserved because of positive cranial margins or involved lymph nodes in almost one third of patients originally referred for radical trachelectomy. The main criterion for the selection of suitable patients should be the cranial extent of the tumor. Abdominal radical trachelectomy allows for achievement of satisfactory obstetrical outcomes.
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