Fertility-sparing surgical options in patients with early cervical cancer: Radical vaginal or abdominal trachelectomy?

Pigis D, Thomakos N, Lourantou D, Rodolakis A, Antsaklis A

1st Department of Obstetrics and Gynecology, University of Athens, Alexandra hospital, Athens, Greece

Correspondence: Pigis D, 14 Neapoleos St, GR-15341, Agia Paraskevi, Athens, Greece. E-mail address: This email address is being protected from spambots. You need JavaScript enabled to view it.

 

 

Abstract

Radical trachelectomy has emerged over the last years as a reasonable fertility-sparing operation for selected patients with stage I cervical cancer. The aim of this review was to summarize the latest literature and outline patient selection criteria, operative and oncologic outcomes. The majority of studies on fertility-sparing procedures in early stage cervical cancer examined radical vaginal trachelectomy. Radical abdominal trachelectomy has emerged recently. There have also been reports of more conservative methods such as simple trachelectomy with or without adjuvant chemotherapy. Radical vaginal trachelectomy is well established as a safe and feasible procedure for selected women with early stage cervical cancer, with low rates of recurrence, morbidity and mortality. The use of radical abdominal trachelectomy with pelvic lymphadenectomy in selected patients with stage I cervical cancer who desire to preserve reproductive function has increased. The procedure expands the inclusion criteria of radical vaginal trachelectomy to patients with distorted cervicovaginal anatomy in which the vaginal approach may not be feasible.

Key words: cervical cancer; radical trachelectomy; fertility sparing