Expanding the indications for radical trachelectomy a report on 29 patients with stage Ib1 tumors measuring 2 to 4 centimeters Journal Article
| Authors: | Wethington, S. L.; Sonoda, Y.; Park, K. J.; Alektiar, K. M.; Tew, W. P.; Chi, D. S.; Leitao, M. M.; Jewell, E. L.; Barakat, R. R.; Abu-Rustum, N. R. |
| Article Title: | Expanding the indications for radical trachelectomy a report on 29 patients with stage Ib1 tumors measuring 2 to 4 centimeters |
| Abstract: | Objectives: Radical trachelectomy has enabled select women with stage I cervical cancer to maintain fertility after treatment. Tumor size greater than 2 cm has been considered a contraindication, and those patients denied trachelectomy. We report our trachelectomy experience with tumors measuring 2 to 4 cm. Methods: We retrospectively reviewed the medical records of all patients planned for fertility-sparing radical trachelectomy. Largest tumor dimension was determined by physical examination, preoperative magnetic resonance imaging, or pathologic evaluation. No patient received neoadjuvant chemotherapy. Results: Twenty-nine (26%) of 110 patients had stage IB1 disease with tumors 2 to 4 cm. Median age was 31 years (range, 22Y40 years), and 83% were nulliparous. Thirteen patients (45%) had squamous cell carcinoma, 12 patients (41%) had adenocarcinoma, and 4 patients (14%) had adenosquamous carcinoma. Thirteen (45%) of 29 patients had positive pelvic nodes. All para-aortic nodeswere negative.Owing to intraoperative frozen section, 13 patients (45%) underwent immediate hysterectomy and 1 patient (3%) definitive chemoradiation. Owing to high-risk features on final pathology, 6 patients (21%) who had retained their uterus received chemoradiation. Nine patients (31%) underwent a fertility-sparing procedure. At a median follow-up of 44 months (range, 1Y90 months), there was one recurrence. Conclusions: Expanding radical trachelectomy inclusion criteria towomen with 2- to 4-cm tumors allows for a fertility-sparing procedure in 30% of patients whowould otherwise have been denied the option, with no compromise in oncologic outcome. © 2013 by IGCS and ESGO. |
| Keywords: | trachelectomy; cervical cancer; fertility preservation |
| Journal Title: | International Journal of Gynecological Cancer |
| Volume: | 23 |
| Issue: | 6 |
| ISSN: | 1048-891X |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2013-07-01 |
| Start Page: | 1092 |
| End Page: | 1098 |
| Language: | English |
| DOI: | 10.1097/IGC.0b013e318296034e |
| PROVIDER: | scopus |
| PUBMED: | 23714706 |
| PMCID: | PMC4973580 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 August 2013" - "CODEN: IJGCE" - "Source: Scopus" |
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MSK Authors
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131Jewell -
629Barakat -
710Chi -
333Alektiar -
473Sonoda -
576Leitao -
890Abu-Rustum -
308Park -
19Wethington -
247Tew
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