J Gynecol Oncol.  2014 Jan;25(1):9-13. 10.3802/jgo.2014.25.1.9.

Reproductive outcomes after laparoscopic radical trachelectomy for early-stage cervical cancer

• Park JY
• Kim DY
• Suh DS
• Kim JH
• Kim YM
• Kim YT
• Nam JH

• KMID: 1811182
• DOI: http://doi.org/10.3802/jgo.2014.25.1.9

Abstract

OBJECTIVE
The objective of this study was to estimate the reproductive outcome of young women with early-stage cervical cancer who underwent fertility-sparing laparoscopic radical trachelectomy (LRT).
METHODS
We performed a retrospective review of the medical records of patients with early-stage cervical cancer who underwent LRT. Clinicopathological data were obtained from patient medical records, and reproductive outcome data were obtained from patient medical records and telephone interviews.
RESULTS
Fifty-five patients who underwent successful LRT were included in this study. The median age of patients was 32 years (range, 22 to 40 years), and the median follow-up time after LRT was 37 months (range, 3 to 105 months). Menstruation resumed in all patients after LRT, with fifty patients (90.9%) and five patients (9.1%) reporting regular and irregular menstruation, respectively. Six patients (10.9%) presented with cervical stenosis, which was manifested by regular but decreased menstrual flow and newly-developed dysmenorrhea. These patients underwent cervical cannulation and dilatation. Eighteen patients (32.7%) attempted to conceive, with six out of 18 patients receiving fertility treatments. Fourteen pregnancies (i.e., four missed abortions, six preterm births and four full-term births) occurred in 10 patients after LRT. Nine out of 10 patients gave birth to 10 healthy babies. The pregnancy rate after LRT was 55.6% (10/18). The spontaneous abortion rate and live birth rate were 28.6% (4/14) and 71.4% (10/14), respectively. The preterm birth rate was 60% (6/10).
CONCLUSION
Pregnancy and live birth rates after LRT were promising; however, the preterm birth rate was relatively high. Cervical stenosis also occurred in a small percentage of patients.

Keyword

Cervical cancer; Fertility; Laparoscopic radical trachelectomy; Pregnancy outcome; Reproductive outcome

MeSH Terms

Abortion, Missed
Abortion, Spontaneous
Catheterization
Constriction, Pathologic
Dilatation
Dysmenorrhea
Female
Fertility
Follow-Up Studies
Humans
Interviews as Topic
Live Birth
Medical Records
Menstruation
Parturition
Pregnancy
Pregnancy Outcome
Pregnancy Rate
Premature Birth
Retrospective Studies
Uterine Cervical Neoplasms*

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