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Radical Trachelectomy

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Surgery for Gynecologic Cancer

Part of the book series: Comprehensive Gynecology and Obstetrics ((CGO))

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Abstract

Due to the trends of marrying at a later age and delayed birth, cervical cancer patients who desire fertility-sparing surgery (FSS) are increasing. Radical trachelectomy (RT) which is a FSS is listed in the cervical cancer guidelines and was established as one of the cervical cancer surgery methods. When considering this procedure, oncological outcome and fertility outcome must be considered together. The data of RT and radical hysterectomy (RH) have the same results in oncological outcome. Dargent and colleagues have accumulated reports on the early beginnings of vaginal trachelectomy (VRT), and findings show abdominal trachelectomy (ART) is better recommended for a lesser recurrence rate when the tumor diameter (TD) reaches 2 cm < TD. ART has the highest curability with the RH surgical formula. On the other hand, ART research has reported problems of postoperative complications and pregnancy rates that are not necessarily low, but cannot be considered high. Less invasive surgery for tumors with a TD ≤ 2 cm has been discussed. In addition to ART and VRT, studies including the application of laparoscopic RT and robotic RT have begun. The optimum technique should be decided for each case while considering the TD and fertility result. This is a developing technique, and the accumulation of evidence and further research is warranted for the establishment and selection of adaptation and surgery.

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References

  1. Dargent D, Martin X, Sacchetoni A, Mathevet P. Laparoscopic vaginal radical trachelectomy: a treatment to preserve the fertility of cervical carcinoma patients. Cancer. 2000;88:1877–82.

    Article  CAS  Google Scholar 

  2. Covens A, Shaw P, Murphy J, et al. Is radical trachelectomy a safe alternative to radical hysterectomy for patients with stage IA-B carcinoma of the cervix? Cancer. 1999;86:2273–9.

    Article  CAS  Google Scholar 

  3. Roy M, Plante M. Pregnancies after radical vaginal trachelectomy for early-stage cervical cancer. Am J Obstet Gynecol. 1998;179:1491–6.

    Article  CAS  Google Scholar 

  4. Shepherd JH, Mould T, Oram DH. Radical trachelectomy in early stage carcinoma of the cervix: outcome as judged by recurrence and fertility rates. BJOG. 2001;108:882–5.

    CAS  PubMed  Google Scholar 

  5. Smith JR, Boyle DC, Corless DJ, et al. Abdominal radical trachelectomy: a new surgical technique for the conservative management of cervical carcinoma. Br J Obstet Gynaecol. 1997;104:1196–200.

    Article  CAS  Google Scholar 

  6. Bentivegna E, Maulard A, Pautier P, Chargari C, Gouy S, Morice P. Fertility results and pregnancy outcomes after conservative treatment of cervical cancer: a systematic review of the literature. Fertil Steril. 2016;106:1195–211. e1195

    Article  Google Scholar 

  7. Wethington SL, Sonoda Y, Park KJ, et al. Expanding the indications for radical trachelectomy: a report on 29 patients with stage IB1 tumors measuring 2 to 4 centimeters. Int J Gynecol Cancer. 2013;23:1092–8.

    Article  Google Scholar 

  8. Pareja R, Rendon GJ, Vasquez M, Echeverri L, Sanz-Lomana CM, Ramirez PT. Immediate radical trachelectomy versus neoadjuvant chemotherapy followed by conservative surgery for patients with stage IB1 cervical cancer with tumors 2cm or larger: A literature review and analysis of oncological and obstetrical outcomes. Gynecol Oncol. 2015;137:574–80.

    Article  Google Scholar 

  9. Bafghi A, Castaigne D, Pomel C. Radical trachelectomy: From the laparoscopic approach to the vaginal routeJ Gynecol Obstet Biol Reprod (Paris). 2006;35:696–701.

    Article  CAS  Google Scholar 

  10. Persson J, Kannisto P, Bossmar T. Robot-assisted abdominal laparoscopic radical trachelectomy. Gynecol Oncol. 2008;111:564–7.

    Article  CAS  Google Scholar 

  11. van Gent MD, van den Haak LW, Gaarenstroom KN, et al. Nerve-sparing radical abdominal trachelectomy versus nerve-sparing radical hysterectomy in early-stage (FIGO IA2-IB) cervical cancer: a comparative study on feasibility and outcome. Int J Gynecol Cancer. 2014;24:735–43.

    Article  Google Scholar 

  12. Hamilton BE, Martin JA, Osterman MJ, Curtin SC, Matthews TJ. Births: Final Data for 2014. Natl Vital Stat Rep. 2015;64:1–64.

    PubMed  Google Scholar 

  13. Saito T, Takahashi F, Katabuchi H. Committee on Gynecologic Oncology of the Japan Society of O, Gynecology. Annual Report of the Committee on Gynecologic Oncology, Japan Society of Obstetrics and Gynecology: Patient Annual Report for 2014 and Treatment Annual Report for 2009. J Obstet Gynaecol Res. 2017;43:1667–77.

    Article  Google Scholar 

  14. Yamagami W, Nagase S, Takahashi F, et al. Clinical statistics of gynecologic cancers in Japan. J Gynecol Oncol. 2017;28:e32.

    Article  Google Scholar 

  15. Cui RR, Chen L, Tergas AI, et al. Trends in Use and Survival Associated With Fertility-Sparing Trachelectomy for Young Women With Early-Stage Cervical Cancer. Obstet Gynecol. 2018;131:1085–94.

    Article  Google Scholar 

  16. NCCN Guidelines Version 2. 2018 Cervical cancer. 2018.

    Google Scholar 

  17. Guidelines for treatment of uterine cervical cancer: Japan Society of Gynecologic Oncology(JSGO)2017 edition. 2017.

    Google Scholar 

  18. Okugawa K, Kobayashi H, Sonoda K, et al. Oncologic and obstetric outcomes and complications during pregnancy after fertility-sparing abdominal trachelectomy for cervical cancer: a retrospective review. Int J Clin Oncol. 2017;22:340–6.

    Article  CAS  Google Scholar 

  19. Kobayashi H. Eligibility cliterias and disease outcomes in abdominal radical trachelectomy in our institution. J Jpn Soc Gynecol Oncol. 2011;29(3):668–74.

    Google Scholar 

  20. Koliopoulos G, Sotiriadis A, Kyrgiou M, Martin-Hirsch P, Makrydimas G, Paraskevaidis E. Conservative surgical methods for FIGO stage IA2 squamous cervical carcinoma and their role in preserving women’s fertility. Gynecol Oncol. 2004;93:469–73.

    Article  Google Scholar 

  21. Beiner ME, Hauspy J, Rosen B, et al. Radical vaginal trachelectomy vs. radical hysterectomy for small early stage cervical cancer: a matched case-control study. Gynecol Oncol. 2008;110:168–71.

    Article  CAS  Google Scholar 

  22. Diaz JP, Sonoda Y, Leitao MM, et al. Oncologic outcome of fertility-sparing radical trachelectomy versus radical hysterectomy for stage IB1 cervical carcinoma. Gynecol Oncol. 2008;111:255–60.

    Article  Google Scholar 

  23. Marchiole P, Benchaib M, Buenerd A, Lazlo E, Dargent D, Mathevet P. Oncological safety of laparoscopic-assisted vaginal radical trachelectomy (LARVT or Dargent’s operation): a comparative study with laparoscopic-assisted vaginal radical hysterectomy (LARVH). Gynecol Oncol. 2007;106:132–41.

    Article  Google Scholar 

  24. Xu L, Sun FQ, Wang ZH. Radical trachelectomy versus radical hysterectomy for the treatment of early cervical cancer: a systematic review. Acta Obstet Gynecol Scand. 2011;90:1200–9.

    Article  Google Scholar 

  25. Guo J, Zhang Y, Chen X, Sun L, Chen K, Sheng X. Surgical and oncologic outcomes of radical abdominal trachelectomy versus hysterectomy for stage IA2-IB1 cervical cancer. J Minim Invasive Gynecol. 2018;

    Google Scholar 

  26. Bentivegna E, Gouy S, Maulard A, Chargari C, Leary A, Morice P. Oncological outcomes after fertility-sparing surgery for cervical cancer: a systematic review. Lancet Oncol. 2016;17:e240–53.

    Article  Google Scholar 

  27. Zhang Q, Li W, Kanis MJ, et al. Oncologic and obstetrical outcomes with fertility-sparing treatment of cervical cancer: a systematic review and meta-analysis. Oncotarget. 2017;8:46580–92.

    PubMed  PubMed Central  Google Scholar 

  28. Maneo A, Chiari S, Bonazzi C, Mangioni C. Neoadjuvant chemotherapy and conservative surgery for stage IB1 cervical cancer. Gynecol Oncol. 2008;111:438–43.

    Article  Google Scholar 

  29. Cibula D, Slama J, Svarovsky J, et al. Abdominal radical trachelectomy in fertility-sparing treatment of early-stage cervical cancer. Int J Gynecol Cancer. 2009;19:1407–11.

    Article  Google Scholar 

  30. Du XL, Sheng XG, Jiang T, et al. Sentinel lymph node biopsy as guidance for radical trachelectomy in young patients with early stage cervical cancer. BMC Cancer. 2011;11:157.

    Article  Google Scholar 

  31. Rob L, Charvat M, Robova H, et al. Less radical fertility-sparing surgery than radical trachelectomy in early cervical cancer. Int J Gynecol Cancer. 2007;17:304–10.

    Article  CAS  Google Scholar 

  32. Selman TJ, Mann C, Zamora J, Appleyard TL, Khan K. Diagnostic accuracy of tests for lymph node status in primary cervical cancer: a systematic review and meta-analysis. CMAJ. 2008;178:855–62.

    Article  Google Scholar 

  33. Cao DY, Yang JX, Wu XH, et al. Comparisons of vaginal and abdominal radical trachelectomy for early-stage cervical cancer: preliminary results of a multi-center research in China. Br J Cancer. 2013;109:2778–82.

    Article  CAS  Google Scholar 

  34. Li J, Wu X, Li X, Ju X. Abdominal radical trachelectomy: Is it safe for IB1 cervical cancer with tumors >/= 2 cm? Gynecol Oncol. 2013;131:87–92.

    Article  Google Scholar 

  35. Nishio H, Fujii T, Kameyama K, et al. Abdominal radical trachelectomy as a fertility-sparing procedure in women with early-stage cervical cancer in a series of 61 women. Gynecol Oncol. 2009;115:51–5.

    Article  Google Scholar 

  36. Rob L, Skapa P, Robova H. Fertility-sparing surgery in patients with cervical cancer. Lancet Oncol. 2011;12:192–200.

    Article  Google Scholar 

  37. Lintner B, Saso S, Tarnai L, et al. Use of abdominal radical trachelectomy to treat cervical cancer greater than 2 cm in diameter. Int J Gynecol Cancer. 2013;23:1065–70.

    Article  Google Scholar 

  38. Pareja R, Rendon GJ, Sanz-Lomana CM, Monzon O, Ramirez PT. Surgical, oncological, and obstetrical outcomes after abdominal radical trachelectomy - a systematic literature review. Gynecol Oncol. 2013;131:77–82.

    Article  Google Scholar 

  39. Wethington SL, Cibula D, Duska LR, et al. An international series on abdominal radical trachelectomy: 101 patients and 28 pregnancies. Int J Gynecol Cancer. 2012;22:1251–7.

    Article  Google Scholar 

  40. Saso S, Ghaem-Maghami S, Chatterjee J, et al. Abdominal radical trachelectomy in West London. BJOG. 2012;119:187–93.

    Article  CAS  Google Scholar 

  41. Plante M. Vaginal radical trachelectomy: an update. Gynecol Oncol. 2008;111:S105–10.

    Article  Google Scholar 

  42. Ungar L, Palfalvi L, Hogg R, et al. Abdominal radical trachelectomy: a fertility-preserving option for women with early cervical cancer. BJOG. 2005;112:366–9.

    Article  Google Scholar 

  43. Robova H, Rob L, Halaska MJ, Pluta M, Skapa P. Review of neoadjuvant chemotherapy and trachelectomy: which cervical cancer patients would be suitable for neoadjuvant chemotherapy followed by fertility-sparing surgery? Curr Oncol Rep. 2015;17:446.

    Article  Google Scholar 

  44. Tokunaga H, Watanabe Y, Niikura H, et al. Outcomes of abdominal radical trachelectomy: results of a multicenter prospective cohort study in a Tohoku Gynecologic Cancer Unit. Int J Clin Oncol. 2015;20:776–80.

    Article  Google Scholar 

  45. Carter J, Sonoda Y, Baser RE, et al. A 2-year prospective study assessing the emotional, sexual, and quality of life concerns of women undergoing radical trachelectomy versus radical hysterectomy for treatment of early-stage cervical cancer. Gynecol Oncol. 2010;119:358–65.

    Article  Google Scholar 

  46. Fleming ND, Ramirez PT, Soliman PT, et al. Quality of life after radical trachelectomy for early-stage cervical cancer: A 5-year prospective evaluation. Gynecol Oncol. 2016;143:596–603.

    Article  CAS  Google Scholar 

  47. Vieira MA, Rendon GJ, Munsell M, et al. Radical trachelectomy in early-stage cervical cancer: A comparison of laparotomy and minimally invasive surgery. Gynecol Oncol. 2015;138:585–9.

    Article  Google Scholar 

  48. Li J, Li Z, Wang H, et al. Radical abdominal trachelectomy for cervical malignancies: surgical, oncological and fertility outcomes in 62 patients. Gynecol Oncol. 2011;121:565–70.

    Article  Google Scholar 

  49. Boss EA, van Golde RJ, Beerendonk CC, Massuger LF. Pregnancy after radical trachelectomy: a real option? Gynecol Oncol. 2005;99:S152–6.

    Article  CAS  Google Scholar 

  50. Ogawa S, Kobayashi H, Amada S, et al. Sentinel node detection with (99m)Tc phytate alone is satisfactory for cervical cancer patients undergoing radical hysterectomy and pelvic lymphadenectomy. Int J Clin Oncol. 2010;15:52–8.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Faculty of Medicine, Department of Obstetrics and Gynecology, Kagoshima University, Kagoshima, Japan

    Shintaro Yanazume & Hiroaki Kobayashi

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  1. Shintaro Yanazume
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  2. Hiroaki Kobayashi
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Correspondence to Hiroaki Kobayashi .

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Editors and Affiliations

  1. Department of Obstetrics and Gynecology, School of Medicine, Tokai University, Isehara, Japan

    Mikio Mikami

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Yanazume, S., Kobayashi, H. (2019). Radical Trachelectomy. In: Mikami, M. (eds) Surgery for Gynecologic Cancer. Comprehensive Gynecology and Obstetrics. Springer, Singapore. https://doi.org/10.1007/978-981-13-1519-0_12

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  • DOI: https://doi.org/10.1007/978-981-13-1519-0_12

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