Radical abdominal trachelectomy for stage IB1 cervical cancer at 15-week gestation Journal Article


Authors: Abu-Rustum, N. R.; Tal, M. N.; DeLair, D.; Shih, K.; Sonoda, Y.
Article Title: Radical abdominal trachelectomy for stage IB1 cervical cancer at 15-week gestation
Abstract: Objective: The management of stage IB1 cervical cancer at 15 weeks pregnancy remains a significant challenge from both the oncologic and obstetrical standpoints. Abdominal trachelectomy has been recently described as a potential option in patients who have a very strong desire to attempt preservation of pregnancy and treat the cancer without delay. Case: A 37-year-old female, presented for prenatal care in the first trimester and was diagnosed with a FIGO stage IB1 poorly differentiated lymphoepithelioma like cervical cancer on conization. After extensive counseling she underwent a radical abdominal trachelectomy with pelvic lymphadenectomy and placement of permanent cerclage at 15 weeks gestation. Final trachelectomy pathology revealed 7/19 mm invasion with no lymphovascular invasion, negative margins and nodes. She successfully carried the pregnancy to 39 weeks gestation and delivered a healthy female infant by elective planned cesarean hysterectomy. The patient remains without evidence of disease at the time of this report. Conclusion: Recent advances in fertility-sparing surgery for stage IB1 cervical cancer lead to the successful utilization of radical abdominal trachelectomy during the early second trimester of pregnancy. This approach in early gestation is feasible and resulted in a favorable oncologic and obstetrical outcome. Radical trachelectomy may broaden the treatment options for pregnant women with stage IB1 cervical cancer who have a strong desire to avoid definitive pregnancy termination and commence treatment without delay. © 2009 Elsevier Inc. All rights reserved.
Keywords: adult; case report; hysterectomy; neoplasm staging; pelvis lymphadenectomy; early cancer; gestational age; uterine cervix cancer; pregnancy; abdominal surgery; radical trachelectomy; uterine cervical neoplasms; pregnancy complications, neoplastic; cesarean section; female fertility; pregnancy outcome; elective surgery; cerclage; cervical cancer in pregnancy; first trimester pregnancy
Journal Title: Gynecologic Oncology
Volume: 116
Issue: 1
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2010-01-01
Start Page: 151
End Page: 152
Language: English
DOI: 10.1016/j.ygyno.2009.10.042
PUBMED: 19878979
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 7" - "Export Date: 20 April 2011" - "CODEN: GYNOA" - "Source: Scopus"
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  1. Yukio Sonoda
    472 Sonoda
  2. Karin Kuan-Hui Shih
    41 Shih
  3. Deborah F DeLair
    106 DeLair