Early adenocarcinoma of the cervix: is radical vaginal trachelectomy safe?

Radical vaginal trachelectomy (RVT) is a revolutionary option for fertility preservation in young women with early cervical tumors. Several series have demonstrated outcomes comparable to radical hysterectomy (RH), but none has addressed the influence of histology. We evaluated the safety of RVT in adenocarcinomas. Data on surgically treated adenocarcinoma (AC) and squamous cell carcinoma (SCC) cases was taken from a centralized Toronto Cervical Cancer Database. Prognostically important tumor features, lymph node status, and the use of adjuvant therapies were compared. Adenocarcinoma cases treated with RVT were compared to AC cases treated with RH, and to SCC cases that had RVT. Recurrence-free survival was calculated from the date of surgery. Medians, proportions, and survival curves were compared with the Mann Whitney test, the Chi-square test, and the Log Rank test, respectively. 74 patients with AC and 66 patients with SCC undergoing RVT, and 187 cases of AC undergoing RH were analyzed. Patients undergoing RVT were younger than patients having RH (31 vs. 40, p<0.001). Tumor characteristics were similar, but depth of invasion and the frequency of high grade lesions were higher in the RH group (5 mm vs. 3 mm, p<0.001; and 36% vs. 22%, p=0.04). Adjuvant treatment was given more frequently after RH (12% vs. 3%, p<0.05). There was no significant difference in recurrence-free survival between RH and RVT for AC, or between AC and SCC patients treated by RVT. RVT is a safe alternative for early stage cervical adenocarcinoma in appropriately selected patients wishing to preserve fertility.

Helpman L ，Grisaru D ，Covens A 《-》

Radical vaginal trachelectomy vs. radical hysterectomy for small early stage cervical cancer: a matched case-control study.

Beiner ME ，Hauspy J ，Rosen B ，Murphy J ，Laframboise S ，Nofech-Mozes S ，Ismiil N ，Rasty G ，Khalifa MA ，Covens A ... -  《-》

Radical vaginal trachelectomy (Dargent's operation): a critical review of the literature.

Dursun P ，LeBlanc E ，Nogueira MC 《-》

Oncologic outcome of fertility-sparing radical trachelectomy versus radical hysterectomy for stage IB1 cervical carcinoma.

Diaz JP ，Sonoda Y ，Leitao MM ，Zivanovic O ，Brown CL ，Chi DS ，Barakat RR ，Abu-Rustum NR ... -  《-》

A fertility-preserving option in early cervical carcinoma: laparoscopy-assisted vaginal radical trachelectomy and pelvic lymphadenectomy.

Chen Y ，Xu H ，Zhang Q ，Li Y ，Wang D ，Liang Z ... -  《-》