Initial experience with Dargent's operation: The radical vaginal trachelectomy Journal Article
| Authors: | Sonoda, Y.; Chi, D. S.; Carter, J.; Barakat, R. R.; Abu-Rustum, N. R. |
| Article Title: | Initial experience with Dargent's operation: The radical vaginal trachelectomy |
| Abstract: | Objective.: To report on our initial experience with radical vaginal trachelectomy for patients with early-stage cervical cancer. Methods.: Data on patients undergoing radical vaginal trachelectomy with pelvic lymphadenectomy from 11/01 to 12/06 were collected in a prospective database. Results.: Forty-three women with early-stage cervical cancer were operated on with the intent of fertility preservation with radical vaginal trachelectomy. Median age was 31 years (range, 20-40 years). FIGO stage for the group was: IB1, 28; IA2, 7; IA1 with lymphovascular invasion, 8. Histologic type included: squamous, 24; adenocarcinoma, 16; adenosquamous, 3. Parity for the group was: nullipara, 35; one child, 7; two children, 1. Median BMI was 24 kg/m2 (range, 19-42 kg/m2). Two patients (5%) underwent completion hysterectomy due to extensive endocervical disease. The median OR time was 330 min (range, 220-480 min). Median pelvic lymph node count was 25 (range, 9-52). Median hospital stay was 3 days (range, 3-7 days). Four patients (9%) required a second intervention for a perioperative complication. Five patients (12%) underwent adjuvant chemoradiation for pathologic risk factors determined on final pathology. Eleven (79%) of 14 women who were trying to get pregnant were able to conceive. Four (36%) required assisted reproductive techniques to conceive. Four patients delivered by cesarean section after 35 weeks and four patients are currently pregnant. With a median follow-up of 21 months in patients treated with trachelectomy alone, we have had one recurrence. Conclusions.: Radical vaginal trachelectomy can be incorporated into gynecologic oncology practices and appears to be a reasonable option for patients with early cervical cancer who desire to maintain their fertility. It should be discussed with candidate patients during preoperative consultation. © 2007 Elsevier Inc. All rights reserved. |
| Keywords: | treatment outcome; cancer surgery; surgical technique; major clinical study; cancer recurrence; squamous cell carcinoma; cancer patient; follow up; lymph node metastasis; hysterectomy; pelvis lymph node; laparoscopy; lymph node excision; adenocarcinoma; pathology; risk factor; cancer invasion; body mass; vascular tumor; gynecologic surgical procedures; age distribution; perioperative complication; fertility; uterine cervical neoplasms; gynecologic surgery; trachelectomy; cesarean section; uterine cervix carcinoma; female fertility; cervical cancer; surgical patient; infertility therapy; nullipara; pregnant woman; dargent; vagina trachelectomy |
| Journal Title: | Gynecologic Oncology |
| Volume: | 108 |
| Issue: | 1 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2008-01-01 |
| Start Page: | 214 |
| End Page: | 219 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2007.09.028 |
| PUBMED: | 17996284 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 28" - "Export Date: 17 November 2011" - "CODEN: GYNOA" - "Source: Scopus" |
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473Sonoda -
888Abu-Rustum -
160Carter
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