Journal Browser Advanced Search Help
Journal Browser Advanced search HELP
J Gynecol Oncol. 2019 May;30(3):e34. English. Original Article. https://doi.org/10.3802/jgo.2019.30.e34
Balaya V , Lécuru F , Magaud L , Ngô C , Huchon C , Bats AS , Mathevet P .
Gynecologic and Breast Oncologic Surgery Department, Georges Pompidou European Hospital, Paris, France. vbalaya@hotmail.com
Research unit in Morphogenesis, Radiology and Anatomy EA4465 Paris Descartes Medical School, Paris, France.
Faculty of Medicine, Paris Descartes University, Paris, France.
Hospices Civils de Lyon, Pôle IMER, Lyon, France.
Obstetrics and Gynecology Department, Poissy Medical Center, Poissy, France.
Gynecology Department, University Hospital, University of Lausanne, Lausanne, Switzerland.
Abstract

Objective

The aim of this study was to determine the predictive factors of postoperative morbidity of patients who have undergone a radical trachelectomy (RT) for early-stage cervical cancer and to assess the oncologic outcomes.

Methods

We retrospectively analysed the data of 2 prospective trials on sentinel node biopsy for cervical cancer (SENTICOL I and II). Patients having a RT for early-stage cervical cancer with negative sentinel lymph node and safe margins, were included.

Results

Forty-nine patients met the inclusion criteria. Forty-five patients had a laparoscopic-assisted vaginal technique and 4 patients a total laparoscopic technique. The median age was 32 years (range, 22–46 years). 83.7% of patients had a stage IB1 disease. There were 63.3% squamous cell carcinomas and 34.7% adenocarcinomas. The median follow-up was 46 months (range, 1–85 months). Two patients (3.3%) had a severe postoperative complication (Clavien-Dindo ≥III and/or CTCAE ≥3). The main postoperative complications were urinary (28.6%), lymphovascular (26.5%) and neurologic (14.3%). On a multivariate analysis, postoperative complications were significantly associated with history of pelvic surgery and IB1 International Federation of Gynecology and Obstetrics stage. Inclusion in high surgical skills centers decrease the risk of postoperative complications. During the follow-up, 3 patients (6.1%) had a local recurrence and one patient died from a breast cancer. Between group with complications and group without any complications, overall survival and recurrence-free survival did not significantly differ at 5-year of follow-up.

Conclusion

RT has few severe postoperative complications and appears as a safe alternative to spare fertility of young patients. To guarantee best surgical outcomes, patients should be referred to expert center.

Copyright © 2019. Korean Association of Medical Journal Editors.