Oncologic and obstetric outcomes and complications during pregnancy after fertility-sparing abdominal trachelectomy for cervical cancer: a retrospective review

Okugawa, Kaoru; Kobayashi, Hiroaki; Sonoda, Kenzo; Kaneki, Eisuke; Kawano, Yoshiaki; Hidaka, Noriaki; Egashira, Kensuke; Fujita, Yasuyuki; Yahata, Hideaki; Kato, Kanefusa

doi:10.1007/s10147-016-1059-9

Cited by 68 publications

(72 citation statements)

References 19 publications

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“…Is RT also practical for pregnant patients with early invasive uterine cervical cancer? Not a few institutes in Japan have started to perform RT for patients with early invasive uterine cervical cancer who desire the preservation of fertility . Their oncological results seem to be as good as for radical hysterectomy.…”

Section: Discussionmentioning

confidence: 99%

Obstetrical prognosis of patients who underwent vaginal radical trachelectomy during pregnancy

Umemoto

Ishioka

Mizugaki

et al. 2019

J of Obstet and Gynaecol

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Aim Radical trachelectomy (RT) with pelvic lymphadenectomy has become an option for young patients with early invasive uterine cervical cancer who decide to maintain their fertility. However, this operative method entails a high risk for the following pregnancy due to its radicality. Therefore, RT for pregnant patients can be a challenge both for gynecologic oncologists and obstetricians. Methods We have performed vaginal RT for five pregnant patients with uterine cervical cancer stage 1B1 according to the method of Dargent et al. The operations were performed between 16 and 26 weeks of pregnancy, and the patients were followed up carefully according to the follow‐up methods we reported previously. Results Vaginal RT was performed for five patients without any troubles. Four of the patients continued their pregnancies until almost 34 weeks or longer under our previously published follow‐up schedule. The pregnancy of one patient was terminated at 26 weeks due to recurrence of the cancer. Conclusion Expansion of vaginal RT for pregnant patients with uterine cervical cancer could be a practical option for pregnant patients with early invasive uterine cervical cancer.

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Section: Discussionmentioning

confidence: 99%

Obstetrical prognosis of patients who underwent vaginal radical trachelectomy during pregnancy

Umemoto

Ishioka

Mizugaki

et al. 2019

J of Obstet and Gynaecol

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“…The cervical incision line was 5-10 mm below the internal os, as determined by ultrasonography; intraoperative frozen section at 5 mm from the upper cervical margin was performed to verify the absence of tumor. Trachelectomy was not performed when the SLN was positive for metastasis [8]. Patients who did not meet the above criteria underwent hysterectomy.…”

Section: Surgical Technique and Follow-upmentioning

confidence: 99%

Value of Intraoperative Cytological and Pathological Sentinel Lymph Node Diagnosis in Fertility-Sparing Trachelectomy for Early-Stage Cervical Cancer

et al. 2017

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Background and Objectives: Trachelectomy, a fertility-sparing surgery for early-stage cervical cancer, can be performed only when there is no extrauterine extension present. Therefore, identifying the sentinel lymph nodes (SLNs) and using them to obtain an intraoperative pathologic diagnosis can provide information on the feasibility and safety of trachelectomy. Our aim was to assess the value of an intraoperative SLN diagnosis. Methods: We retrospectively analyzed the accuracy of intraoperative imprint cytology and frozen-section examination in 201 patients at our institution in whom trachelectomy was planned. Results: All patients could be evaluated for SLNs; a total of 610 SLNs were analyzed. Although the specificity of both imprint cytology and frozen-section examination was 100.0%, the sensitivity was only 58.6 and 65.5%, respectively. The diagnostic sensitivity was higher in 2-mm slices along the short axis than on bisection along the longitudinal axis. Imprint cytology correctly diagnosed 2 patients who had false-negative results on frozen section. The nature of the metastatic foci that caused an intraoperative false-negative diagnosis was either micrometastasis or isolated tumor cells. Conclusions: The accuracy of intraoperative SLN diagnosis requires improvement, especially when small metastatic foci are present.

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“…Okugawa et al reported a successful pregnancy rate of 25% post-trachelectomy in a series of 151 patients 4. To date, this procedure has only been performed in benign symptomatic cervical lesions in three patients 15.…”

Section: Discussionmentioning

confidence: 99%

“…Radical abdominal trachelectomy has been described in the management of selected premenopausal patients with early cervical cancer in an attempt to maintain reproductive potential 4. Reported rates of successful conception post trachelectomy range from 30% to 66% 4–6.…”

Section: Introductionmentioning

confidence: 99%

Novel management of a giant cervical myoma in a premenopausal patient

et al. 2017

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Cervical myomas are rare and account for <1% of uterine leiomyomas. Clinical complications include bulk-related symptoms of pelvic pain, abnormal bleeding and infertility. While hysterectomies may be readily performed for postmenopausal women; the management of women with cervical myomas of childbearing age remains a challenge.Traditionally described fertility-preserving procedures such as myomectomy, endometrial ablation or myolysis may only be applied to leiomyomas within the uterine corpus. Little is known about the surgical management of its cervical counterpart.Radical abdominal trachelectomy has been described as a potential fertility-preserving procedure in the management of women with early cervical cancer. As such, we present a case of a giant cervical myoma that was treated with an abdominal trachelectomy in an attempt to preserve fertility.

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Oncologic and obstetric outcomes and complications during pregnancy after fertility-sparing abdominal trachelectomy for cervical cancer: a retrospective review

Cited by 68 publications

References 19 publications

Obstetrical prognosis of patients who underwent vaginal radical trachelectomy during pregnancy

Obstetrical prognosis of patients who underwent vaginal radical trachelectomy during pregnancy

Value of Intraoperative Cytological and Pathological Sentinel Lymph Node Diagnosis in Fertility-Sparing Trachelectomy for Early-Stage Cervical Cancer

Novel management of a giant cervical myoma in a premenopausal patient

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