A fertility-sparing alternative to radical hysterectomy: how many patients may be eligible?

Gynecol Oncol. 2004 Dec;95(3):534-8. doi: 10.1016/j.ygyno.2004.07.060.

Abstract

Objective: To determine the percentage of patients with early-stage cervical cancer who may be eligible for fertility preservation with laparoscopic radical vaginal trachelectomy (LRVT).

Methods: We retrospectively reviewed the records of patients who underwent a radical hysterectomy for invasive cervical cancer at our institution from 12/85 to 8/01, before our use of LRVT at Memorial Sloan-Kettering Cancer Center. Institutional eligibility criteria for LRVT were applied. Patients > or =40 years of age were considered ineligible.

Results: We identified 435 patients who had undergone radical hysterectomy for cervical cancer; 186 were age < 40 at surgery and constituted our study population. Eighty-nine (48%) patients may have been eligible by our pathologic criteria. In 12 patients, LRVT may have been aborted or altered because of unexpected disease spread.

Conclusion: A significant number of patients < 40 with early-stage cervical cancer may be pathologically eligible for LRVT and should be counseled on this preoperatively.

MeSH terms

  • Adult
  • Female
  • Fertility
  • Gynecologic Surgical Procedures / methods*
  • Humans
  • Hysterectomy
  • Laparoscopy / methods
  • Neoplasm Staging
  • Retrospective Studies
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / surgery*