Long-term outcomes of radical vaginal trachelectomy and laparoscopic pelvic lymphadenectomy after neoadjuvant chemotherapy for the IB1 cervical cancer: a series of 60 cases

• Published in: International journal of surgery (London, England) Vol. 29; pp. 38 - 42
• Main Authors: Yan, Hong, Liu, Zhongyu, Fu, Xiaoyu, Li, Yan, Che, Hongzhi, Mo, Rui, Song, Prof Lei
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.05.2016
• Subjects: Adult; Cervix Uteri - surgery; Chemotherapy, Adjuvant; Early-stage cervical cancer; Female; Fertility-preserving surgery; Follow-Up Studies; Humans; Laparoscopy; Lymph Node Excision - methods; Lymph Nodes - pathology; Lymph Nodes - surgery; Neoadjuvant chemotherapy; Neoadjuvant Therapy - methods; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Pelvis - surgery; Pregnancy; Pregnancy Rate; Prospective Studies; Radical vaginal trachelectomy; Surgery; Trachelectomy - methods; Treatment Outcome; Uterine Cervical Neoplasms - drug therapy; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - surgery; Vagina - surgery; Young Adult; Neoadjuvant chemotherapy; Fertility-preserving surgery; Early-stage cervical cancer; Radical vaginal trachelectomy
• ISSN: 1743-9191; 1743-9159
• DOI: 10.1016/j.ijsu.2016.03.019

Abstract Objects The present study sought to analyze the long-time clinical outcomes of the stage IB1 cervical cancer patients who had received the radical vaginal trachelectomy (RVT) and laparoscopic lymphadenectomy after neoadjuvant chemotherapy (NACT). Method This is a prospective study of 60 patients potentially selected for RVT for a clinical and radiologic cervical cancer (stages IB 1) less than 2 cm. These patients were treated with surgery combined with preoperative NACT in the Department of Obstetrics and Gynecology, PLA General Hospital. We collected the patients’ general clinical information, surgical characteristics and obstetric data, and then assessed their long-term oncological outcomes. Results The average operative time of the enrolled cases was 204 min and the average blood loss was 443mL. The average postoperative hospitalization time was 10.6 days. The postoperative pathologic results indicated that the average parametrical width was 1.99 cm; the average length of removed of cervical was 2.6 cm; the average number of excised pelvic lymph node was 20. The median of the follow-up was 43 months (range between 13month --12 years). Only one case of recurrence was found. Thus far, totally 42 women had tried to conceive, and 36 of them had live births. The live birth pregnancy rate was 86% (36/42). Conclusion The radical vaginal trachelectomy in combination with the laparoscopic lymphadenectomy surgical is a safe and effective therapeutic strategy for the for IB 1 cervical cancer.