A less radical treatment option to the fertility-sparing radical trachelectomy in patients with stage I cervical cancer

Gynecologic Oncology
Lukas RobHelena Robova

Abstract

The purpose of the two pilot studies was to determine the feasibility and safety of using less-radical fertility-preserving surgery: laparoscopic lymphadenectomy with sentinel lymph node identification (SLNI) followed by a large cone or simple trachelectomy (LAP-I protocol) and the LAP-III protocol, which includes neoadjuvant chemotherapy (NAC). LAP-I: Forty women underwent laparoscopic SLNI, frozen-section analysis, and a complete pelvic lymphadenectomy as the first step of treatment. Seven days after final histopathological processing of dissected nodes, a large cone or simple vaginal trachelectomy was performed in patients with negative nodes. Nine women had a tumor larger than 20 mm, prompting the administration of three cycles of NAC before surgery. LAP-I: Six frozen sections were positive (15%). In these cases, a type III Wertheim was immediately performed. There were no false-negative SLNs. There was one central recurrence, but after chemoradiation therapy, there was no evidence of the disease 62 months post-treatment. Twenty-four of 32 women whose reproductive ability had been maintained tried to conceive. Of these 24 women, 17 became pregnant (71% pregnancy rate). Eleven mothers gave birth to 12 children (1 at 24 weeks...Continue Reading

References

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Citations

Nov 26, 2013·Gynécologie, obstétrique & fertilité·M TrudelP Collinet
Jun 27, 2009·Annals of Oncology : Official Journal of the European Society for Medical Oncology·L VerleyeP B Ottevanger
Sep 5, 2012·Current Oncology Reports·Stefano Greggi, Cono Scaffa
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Jan 27, 2016·Current Treatment Options in Oncology·Federica TomaoFabio Landoni
Nov 8, 2012·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·O GemerO Lavie
Oct 28, 2011·Surgical Oncology·Pierre LoubeyrePatrick Petignat
Feb 16, 2011·Gynecologic Oncology·Kathleen M SchmelerPedro T Ramirez
Jan 5, 2011·Journal of Minimally Invasive Gynecology·Innocenza PalaiaPierluigi Benedetti Panici
Dec 3, 2010·Fertility and Sterility·Anna FagottiFrancesco Fanfani
Jul 27, 2010·Fertility and Sterility·Pascale JadoulJacques Donnez
Jul 14, 2010·The Lancet Oncology·Lukas RobHelena Robova
Feb 19, 2010·Gynecologic Oncology·Lilian T Gien, Allan Covens
Mar 6, 2010·The Lancet Oncology·Lukas RobHelena Robova
Sep 22, 2009·Gynécologie, obstétrique & fertilité·R LousquyE Barranger
Jul 26, 2012·International Journal of Surgical Oncology·Adelaide Fernanda Ribeiro CubalAna Paula Tavares Branco
Dec 4, 2014·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Luiza D PeculisNeville Hacker
Dec 3, 2014·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·S KadkhodayanR Sadeghi
Jun 14, 2012·International Journal of Hyperthermia : the Official Journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group·Lukas RobPetr Skapa
Apr 3, 2012·Gynecologic Oncology·Ioannis BiliatisRaj Naik
Apr 11, 2012·Gynecologic Oncology·Innocenza PalaiaPierluigi Benedetti Panici
Jul 19, 2011·Placenta·D VitobelloP E Levi Setti
Sep 7, 2011·Gynecologic Oncology·Anne-Sophie BatsUNKNOWN SENTICOL collaborative group
Feb 1, 2014·Gynecologic Oncology·Geneviève Bouchard-FortierAllan Covens
Jul 19, 2013·Gynecologic Oncology·Clare J ReadeAllan Covens

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