Radical vaginal trachelectomy and laparoscopic pelvic lymphadenectomy in IB1 cervical cancer during pregnancy

Bravo, Erasmo; Parry, S.; Alonso, Catalina; Rojas, Sergio

doi:10.1016/j.gynor.2012.04.002

Cited by 9 publications

(5 citation statements)

References 9 publications

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“…Most of them were carried out during the second trimester, and only 8 cases were performed during the first trimester, 3,11,17,19 and 4 of these ended in miscarriage (day 1, 3 day 2, 19 and day 7 11 ). Among the 18 cases that were carried out during the second trimester, one case ended in miscarriage (day 17) 3 and a fetus death was reported 4 hours after the ART in another case, in a 22-week pregnancy, in which both uterine arteries were ligated and paraortic lymphadenectomy was included.…”

Section: Resultsmentioning

confidence: 99%

Abdominal Radical Trachelectomy for Early-Stage Cervical Cancer During Pregnancy: A Provocative Surgical Approach. Overview of the Literature and a Single-Institute Experience

Rodolakis

Thomakos

Sotiropoulou³

et al. 2018

Int J Gynecol Cancer

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ObjectiveTreatment of pregnancy complication due to malignancy of the cervix constitutes a great clinical challenge between optimal maternal therapy and fetal viability. Radical trachelectomy in early-stage cervical cancer during pregnancy instead of radical hysterectomy presents an alternative approach that can offer a satisfactory outcome for the mother and fetus.Materials and Methods–ResultsA literature search of articles in English has been performed. Until now, 28 women with cervical cancer, including 2 who were managed and treated in our institute, who underwent a radical trachelectomy during pregnancy have been reported. We overviewed a total of 13 abdominal trachelectomies, 13 vaginal trachelectomies, and 2 laparoscopic trachelectomies.ConclusionsRadical trachelectomy can widen the therapeutic approach of early-stage cervical cancer in pregnant women who wish to preserve their pregnancy, providing a possibility of receiving the proper treatment with no delay.

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Section: Resultsmentioning

confidence: 99%

Abdominal Radical Trachelectomy for Early-Stage Cervical Cancer During Pregnancy: A Provocative Surgical Approach. Overview of the Literature and a Single-Institute Experience

Rodolakis

Thomakos

Sotiropoulou³

et al. 2018

Int J Gynecol Cancer

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“…The other 15, abort their surgery for pelvic lymph node metastatic tumor (13 patients) or major commitment to initiate proceedings vaginal (2 patients). Ten patients undergoing trachelectomy, one with 11 weeks gestation, published during 2012 in Ginecologic Oncology Case Reports [9]. The average duration of 220 minutes is lower than Pahisa's 260.…”

Section: Discussionmentioning

confidence: 95%

Radical Vaginal Hysterectomy and Trachelectomy in Early-Stage Cervical Cancer

Bravo¹,

Montemurro²,

Sepulveda³

et al. 2014

OJOG

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Objective: To communicate a minimally invasive technique for surgical handling of early-stage cervical cancer and its results. Methods: 110 patients with cervical cancer in stages IA2 and IB1, all of them operated in a period of 5 years in both hospitals, are presented. Laparoscopic systemic pelvic lymphadenectomy with radical vaginal hysterectomy or radical vaginal trachelectomy was performed to patients, with the exception of those patients who had compromised nodes detected in contemporary biopsy. Results: Between April 2008 and May 2013, 110 patients were submitted to this technique. 15 patients had their surgery aborted: 13 presented positive nodes for carcinoma in contemporary biopsy and 2 had extensive cervical compromise when performing radical vaginal hysterectomy or trachelectomy. Analysis of the remaining 95 cases shows an average age of 43.9 years (26-61), all of them had given birth before, 23 (21%) of them through C-section. BMI averaged 30.5 and 31 (28.2%) had cone surgery performed previously. Average duration of surgery was of 220 minutes. Postoperative hospitalization averaged 3.1 days. Bleeding volume was estimated at 125 cc and one patient required blood transfusion. En 25 patients' uterine annexes were kept and all of them were suspended by means of laparoscopy. On average, 25.4 pelvic nodes were obtained. Complications 13.6% with eight patients suffered bladder injury, two had rectovaginal fistula, 3 patients requires surgical repair of ureteral obstruction, two patients present thromboembolic disease. The disease-free and overall survivals are consistent with reports in the literature. Conclusion: We believe that handling patients with this technique is possible and has the advantages of vaginal and laparoscopic surgery with minimal complications.

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“…From an oncological point of view, a systematic review totaling more than 600 cases confirmed an overall recurrence rate < 5% and a death rate < 3%, demonstrating the safety of this approach for small invasive cervical tumors [55]. RT in pregnancy has been investigated by many teams, as first-line therapy for patients diagnosed with tumors <2 cm (≤IB1 according to FIGO 2018) [33,[56][57][58][59][60][61][62][63][64][65][66] or, in rarer situations, for patients diagnosed with tumors >2 cm (≥IB2 according to FIGO 2018) [67][68][69][70][71][72][73][74][75]. RT can be performed either through abdominal [58][59][60]63,66,67,69,72,74,76] or vaginal approach (Dargent's method) [56,57,61,71,73,75,77,78], each technique being associated with its own advantages and drawbacks.…”

Section: Surgery Conization and Trachelectomymentioning

confidence: 97%

“…RT in pregnancy has been investigated by many teams, as first-line therapy for patients diagnosed with tumors <2 cm (≤IB1 according to FIGO 2018) [33,[56][57][58][59][60][61][62][63][64][65][66] or, in rarer situations, for patients diagnosed with tumors >2 cm (≥IB2 according to FIGO 2018) [67][68][69][70][71][72][73][74][75]. RT can be performed either through abdominal [58][59][60]63,66,67,69,72,74,76] or vaginal approach (Dargent's method) [56,57,61,71,73,75,77,78], each technique being associated with its own advantages and drawbacks. Vaginal approach allows for less manipulation of the pregnant uterus and thus may carry a lower risk of spontaneous abortion.…”

Section: Surgery Conization and Trachelectomymentioning

confidence: 99%

Cervical Cancer Associated with Pregnancy: Current Challenges and Future Strategies

Le Guévelou,

Selleret,

Laas

et al. 2024

Cancers

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Cancer during pregnancy is defined as a tumor diagnosed in a pregnant woman or up to 1-year post-partum. While being a rare disease, cervical cancer is probably one of the most challenging medical conditions, with the dual stake of treating the cancer without compromising its chances for cure, while preserving the pregnancy and the health of the fetus and child. To date, guidelines for gynecological cancers are provided through international consensus meetings with expert panels, giving insights on both diagnosis, treatment, and obstetrical care. However, these expert guidelines do not discuss the various approaches than can be found within the literature, such as alternative staging modalities or innovative surgical approaches. Also, the obstetrical care of women diagnosed with cervical cancer during pregnancy requires specific considerations that are not provided within our current standard of care. This systematic review aims to fill the gap on current issues with regards to the management of cervical cancer during pregnancy and provide future directions within this evolving landscape.

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Radical vaginal trachelectomy and laparoscopic pelvic lymphadenectomy in IB1 cervical cancer during pregnancy

Abstract: ► We expose an novel surgical technique in pregnant women with cervical cancer. ► We preserve the pregnancy in this case. ► After 40 months of monitoring both patient and her child are healthy.

Cited by 9 publications

References 9 publications

Abdominal Radical Trachelectomy for Early-Stage Cervical Cancer During Pregnancy: A Provocative Surgical Approach. Overview of the Literature and a Single-Institute Experience

Abdominal Radical Trachelectomy for Early-Stage Cervical Cancer During Pregnancy: A Provocative Surgical Approach. Overview of the Literature and a Single-Institute Experience

Radical Vaginal Hysterectomy and Trachelectomy in Early-Stage Cervical Cancer

Cervical Cancer Associated with Pregnancy: Current Challenges and Future Strategies

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