scholarly journals Radical treachelectomy in treatment of early stages of cervical cancer

2008 ◽  
Vol 55 (4) ◽  
pp. 93-97
Author(s):  
K. Jeremic ◽  
S. Petkovic ◽  
A. Stefanovic ◽  
M. Gojnic ◽  
M. Maksimovic ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radiation Therapy ◽  
Radical Hysterectomy ◽  
Diagnostic Method ◽  
Early Stage ◽  
Radical Trachelectomy ◽  
Residual Cancer ◽  
Early Stage Cervical Cancer ◽  
Early Cervical Cancer

The aim of the study was to determine if radical trachelectomy with pelvic lymphonodectomy could be a method for treatment of early cervical cancer to preserve fertility. We examined 12 patients who were operatively treated from 1996. to 2006. year. Diagnostic method for cervical cancer was histologic examination, cone or biopsy. Histologic condition was planocelular carcinoma well differenced. Two of the patients had Ia1 stage, seven had Ia2, and three of them had Ib1. We performed abdominal radical trachelectomy with pelvic lymphonodectomy. Resectional edges were patohistologically analyzed ex tempore, as well as lymphonodi, selectively. According to ex tempore analysis we determined if the radical trachelectomy should be done. In one patient resectional edges were positive, so she underwent radical hysterectomy. Postoperatively we found a positive lymphonodus in one patient, so we continued radiation therapy. In twoyear follow-up period we did not find any sign of residual cancer. We concluded that radical trachelectomy with pelvic lymphonodectomy could be appropriate method for treatment of early stage cervical cancer.

Intention-to-Treat Analysis of Radical Trachelectomy for Early-Stage Cervical Cancer With Special Reference to Oncologic Failures: Single-Institutional Experience in Hungary

2017 ◽  
Vol 27 (7) ◽  
pp. 1438-1445 ◽  
Author(s):  
Robert Póka ◽  
Szabolcs Molnár ◽  
Péter Daragó ◽  
János Lukács ◽  
Rudolf Lampé ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Pelvic Lymphadenectomy ◽  
Radical Trachelectomy ◽  
Eligibility Criteria ◽  
Prognostic Features ◽  
Early Stage Cervical Cancer ◽  
Oncologic Treatment

ObjectiveThe aim of our study was to evaluate clinical and pathological data in order to draw eligibility criteria for oncologically sufficient radical trachelectomy (RT) in early-stage cervical cancer. Reviewing all cases of attempted RT performed at our unit, we focused attention on prognostic indicators of the need for additional oncologic treatment following RT. The analysis was extended by extensive literature review to include previously published cases of oncologic failures.MethodsThe authors retrospectively analyzed data of patients who underwent RT at the Department of Obstetrics and Gynecology, University of Debrecen. Electronic records and case notes of RT cases were reviewed to determine the incidence of abdominal and vaginal route, distribution of clinicopathologic data, and follow-up results of individual cases. Individual procedures were categorized as oncologically insufficient if additional oncologic treatment was necessary following RT. Theoretical eligibility criteria for RT in early-stage cervical cancer were determined retrospectively by selecting prognostic features that were associated with oncologic insufficiency from clinicopathologic indicators of the complete series.ResultsTwenty-four cases of RT were performed by the authors, 15 vaginal RTs with laparoscopic pelvic lymphadenectomy and 9 abdominal RTs with open pelvic lymphadenectomy. Fifteen of 24 cases proved oncologically sufficient. Three cases required immediate conversion to radical hysterectomy because of positive sentinel nodes and/or positive isthmic disc on frozen section. In further 5 cases, final pathology results indicated additional oncologic treatment, that is, radical hysterectomy (n = 2), chemoradiotherapy (n = 2), or chemotherapy (n = 1). One patient among immediately converted cases and another 3 among those who required additional oncologic treatment died of their disease later. There were no other cases of recurrences over a median follow-up of 34 months (range, 12–188 months). Factors that may predict oncologic insufficiency of RT were stage IB1 or greater, tumor size of greater than 2 cm in 1 dimension or greater than 15 mm in 3 dimensions, G3, nonsquamous/adeno histological type, stromal invasion of greater than 9 mm, and lymphovascular space involvement in the primary tumor.ConclusionsMost cases of oncologically insufficient RTs have significant risk features that can be identified preoperatively. There is a need for more clinicopathologic data on oncologic failure of RT cases in order to improve patient selection.

scholarly journals Early cervical cancer recurred with uterine fundus metastasis after laparoscopic fertility-sparing surgery: A case report

2020 ◽  
Author(s):  
yuanming shen ◽  
Xiaoyun Wan ◽  
Jihong Liu ◽  
Xing Xie
Keyword(s):  
Cervical Cancer ◽  
Minimally Invasive ◽  
Squamous Cell ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Radical Trachelectomy ◽  
Fertility Sparing Surgery ◽  
Fertility Sparing ◽  
Early Stage Cervical Cancer ◽  
Uterine Fundus

Abstract Purpose: Recently, the safety of minimally invasive radical hysterectomy for cervical cancer caused widespread controversy. The value of minimally invasive fertility-sparing surgery for early stage cervical cancer is still lacking evidence of randomized controlled trial (RCT).Methods: Here we present a case of stage IB3 (FIGO2018) cervical carcinoma undergone neoadjuvant chemotherapy plus laparoscopic radical trachelectomy (A clinical trial NCT02624531) because of strongly desiring to preserve the fertility. Nine months after the initial treatment, the patient was presented with a uterine fundus mass and elevated serum squamous cell antigen (SCC Ag) and OC125 antigen (CA125).Results: Cervical cancer uterine fundus involvement may occur with advanced tumor stage. Early stage cervical cancer relapsed with a uterine fundus metastasis after laparoscopic radical trachelectomy is exceptionally rare. The patient was treated and cured by a radical hysterectomy. Post-operative pathology confirmed an isolated implanted squamous cell carcinoma in uterine fundus and no previous surgical margins and endometria were involved.Conclusions: This firstly reported case indicates that the safety of laparoscopic radical trachelectomy is still uncertain for advanced stage cervical cancer even if neoadjuvant and post-surgery chemotherapy is given, and also suggests that it is needed to discuss carefully the benefit and risk of such a strategy with the patient when the fertility preservation is considered.

Surgical and Pathological Outcomes of Abdominal Radical Trachelectomy Versus Hysterectomy for Early-Stage Cervical Cancer

2014 ◽  
Vol 24 (7) ◽  
pp. 1312-1318 ◽  
Author(s):  
Dandan Zhang ◽  
Jin Li ◽  
Huijuan Ge ◽  
Xingzhu Ju ◽  
Xiaojun Chen ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Early Stage ◽  
Statistical Tests ◽  
Operation Time ◽  
Radical Trachelectomy ◽  
Accurate Analysis ◽  
Positive Rate ◽  
Early Stage Cervical Cancer ◽  
To Receive

ObjectivesThe aim of this study was to compare the surgical and pathological outcomes for patients with early-stage cervical cancer after abdominal radical trachelectomy (ART) and abdominal radical hysterectomy (ARH).MethodsA prospective database of ART and ARH procedures performed in a standardized manner by the same surgical group was analyzed. The 3-segment technique was used for the accurate analysis of parametrial lymph nodes (PMLNs), and parametrial measurements were recorded by the same pathologist. Standard statistical tests were used.ResultBetween August 2012 and August 2013, ART was attempted in 39 patients (28.6%), and ARH was attempted in 90 patients (71.4%). The parametrium resection length was similar with ART and ARH (44.60 vs 45.48 mm, P = 0.432), as were additional surgical and pathological outcomes, including histology, lymph node positive rate, and operation time. The PMLNs were found in 28 patients (77.78%) in the ART group and in 86 (95.56%) in the ARH group (P > 0.05). Solitary PMLN metastases were observed in 3 patients (10.71%) in the ART group and in 6 (6.98%) in the ARH group. Five (55.6%) of these 9 patients had tumors of 2 cm or greater. The ARH patients (36, 40.00%) were more likely to receive postoperative chemotherapy or radiation compared with ART patients (13, 33.33%; P = 0.017). At a median follow-up of 12 and 12.5 months (P = 0.063), respectively, there were no recurrences or deaths in the ART or ARH groups.ConclusionsUsing standardized techniques, ART provides similar surgical and pathological outcomes as ARH. For the patients with tumors of 2 cm or greater, PMLNs should be examined carefully. Further prospective data are urgently needed.

scholarly journals Results from Survey to Assess Current Trends in Surgical Practice in the Management of Women with Early Stage Cervical Cancer within the BGCS Community with an Emphasis on Routine Frozen Section Examination

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Kumar Gubbala ◽  
Alexandros Laios ◽  
Thulumuru Kavitha Madhuri ◽  
Pubudu Pathiraja ◽  
Krishnayan Haldar ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Frozen Section ◽  
Pelvic Lymphadenectomy ◽  
Frozen Section Examination ◽  
Fertility Sparing ◽  
Early Stage Cervical Cancer ◽  
Early Cervical Cancer ◽  
The Uk

In the UK, more than 3,200 new cases of cervical cancer are diagnosed each year. Early stage cervical cancer (IA2-IB1) treatment comprises central surgery mainly in the form of radical hysterectomy or fertility sparing surgery including trachelectomy as well as systematic pelvic lymphadenectomy to detect metastases and adjust treatment accordingly. Given the variation in determining the lymph node (LN) status, a major prognosticator, we reviewed the current UK practice of LN assessment in women undergoing surgery for early cervical cancer. A 7-question, web-based survey, screened by the BGCS committee, was circulated amongst BGCS members. The overall response rate was 51%. Only 12.5% of the respondents routinely performed frozen section examination (FSE); the main reasons for not doing FSE were the pressure on theatre time (54.5%) and the lack of available facilities (48.5%). When positive pelvic nodal disease was detected, in 21 out of 50 (42%) the planned radical hysterectomy (RH) was aborted. More than 70% of the respondents routinely performed RH without any prior resort to pelvic lymphadenectomy. Pretreatment surgical para-aortic LN assessment was performed by 20% of the respondents. The survey confirms the diversity of the UK practice patterns in the surgical treatment of early cervical cancer.

scholarly journals Early cervical cancer recurred with uterine fundus metastasis after laparoscopic fertility-sparing surgery: A case report

2020 ◽  
Author(s):  
yuanming shen ◽  
Xiaoyun Wan ◽  
Jihong Liu ◽  
Xing Xie
Keyword(s):  
Cervical Cancer ◽  
Minimally Invasive ◽  
Squamous Cell ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Radical Trachelectomy ◽  
Fertility Sparing Surgery ◽  
Fertility Sparing ◽  
Early Stage Cervical Cancer ◽  
Uterine Fundus

Abstract Purpose: Recently, the safety of minimally invasive radical hysterectomy for cervical cancer caused widespread controversy. The value of minimally invasive fertility-sparing surgery for early stage cervical cancer is still lacking evidence of randomized controlled trial (RCT).Methods: Here we present a case of stage IB3 (FIGO2018) cervical carcinoma undergone neoadjuvant chemotherapy plus laparoscopic radical trachelectomy (A clinical trial NCT02624531) because of strongly desiring to preserve the fertility. Nine months after the initial treatment, the patient was presented with a uterine fundus mass and elevated serum squamous cell antigen (SCC Ag) and OC125 antigen (CA125).Results: Cervical cancer uterine fundus involvement may occur with advanced tumor stage. Early stage cervical cancer relapsed with a uterine fundus metastasis after laparoscopic radical trachelectomy is exceptionally rare. The patient was treated and cured by a radical hysterectomy. Post-operative pathology confirmed an isolated implanted squamous cell carcinoma in uterine fundus and no previous surgical margins and endometria were involved.Conclusions: This firstly reported case indicates that the safety of laparoscopic radical trachelectomy is still uncertain for advanced stage cervical cancer even if neoadjuvant and post-surgery chemotherapy is given, and also suggests that it is needed to discuss carefully the benefit and risk of such a strategy with the patient when the fertility preservation is considered.

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