To describe a case series of early-stage cervical cancer patients treated with excisional cone instead of radical trachelectomy as fertility-sparing surgery.Prospective study.University hospital.Early-stage cervical cancer (International Federation of Gynecology and Obstetrics stage IA2-IB1), age ≤ 45 years, tumor ≤ 20 mm.Cold-knife conization and laparoscopic pelvic lymphadenectomy.Recurrence and pregnancy rate.There were 17 patients: 4 (23.5\%) IA2, 13 (76.5\%) IB1; 12 (70.5\%) squamous cell carcinoma, 4 (23.5\%) adenocarcinoma, and 1 (6\%) glassy cell tumor. Four cases (23.5\%) involved lymphovascular space invasion. The median number of lymph nodes removed was 18 (range 13-51). None of the patients received neoadjuvant chemotherapy, and two patients (12\%) received three courses of adjuvant chemotherapy. No recurrences were observed after a median follow-up of 16 months (range 8-101 months). Two of five patients (40\%) attempting to conceive had a spontaneous pregnancy and delivery.In selected and informed patients, conization and laparoscopic pelvic lymphadenectomy seems to be feasible as a fertility-sparing surgical approach.
Excisional cone as fertility-sparing treatment in early-stage cervical cancer.
FAGOTTI, Anna;
2011
Abstract
To describe a case series of early-stage cervical cancer patients treated with excisional cone instead of radical trachelectomy as fertility-sparing surgery.Prospective study.University hospital.Early-stage cervical cancer (International Federation of Gynecology and Obstetrics stage IA2-IB1), age ≤ 45 years, tumor ≤ 20 mm.Cold-knife conization and laparoscopic pelvic lymphadenectomy.Recurrence and pregnancy rate.There were 17 patients: 4 (23.5\%) IA2, 13 (76.5\%) IB1; 12 (70.5\%) squamous cell carcinoma, 4 (23.5\%) adenocarcinoma, and 1 (6\%) glassy cell tumor. Four cases (23.5\%) involved lymphovascular space invasion. The median number of lymph nodes removed was 18 (range 13-51). None of the patients received neoadjuvant chemotherapy, and two patients (12\%) received three courses of adjuvant chemotherapy. No recurrences were observed after a median follow-up of 16 months (range 8-101 months). Two of five patients (40\%) attempting to conceive had a spontaneous pregnancy and delivery.In selected and informed patients, conization and laparoscopic pelvic lymphadenectomy seems to be feasible as a fertility-sparing surgical approach.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
