Successful Term Pregnancy Following Radical Trachelectomy and Laparoscopic Lymphadenectomy in a Patient with Invasive Cervical Squamous Cell Carcinoma: The First Case Reported from Iran (original) (raw)
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Gynecological Surgery, 2008
Fertility-conserving surgical treatment of patients with early stage cervical cancer poses a particular challenge. In specialist centres, trachelectomy with laparoscopic lymphadenectomy could be established as a minimally invasive, fertilitypreserving alternative to radical hysterectomy for women of child-bearing age. This report describes the case of a 33-yearold patient who wished to conceive and was diagnosed with cervical cancer stage pT1a1 in 2004. The patient conceived 9 months after surgery and gave birth to a healthy baby girl at 38+0 weeks. Complications during pregnancy were gestational diabetes, premature contractions and pre-eclampsia at 37 weeks. The advantages and disadvantages of this method as well as the specific antenatal monitoring required are discussed. Keywords Trachelectomy. Cervical cancer. Fertility-conserving treatment Course of events Colposcopy The patient first presented in the dysplasia clinic of the Universitäts-Frauenklinik Tübingen in June 2004 because of a PAP IVa cervical smear. A colposcopic biopsy from this
Oncology Reports, 2013
Radical trachelectomy (RT) can be performed vaginally or abdominally (laparotomic, laparoscopic or robotic). The aim of this systematic review was to compare all techniques in terms of surgical complications, disease recurrence and subsequent fertility/pregnancy outcomes. A total of 1293 RTs were analyzed (FIGO-stage: IA1-IIA). The most frequent surgical complications do not differ from the ones of radical hysterectomy. The recurrence risk is approximately 3% (range 0-16.8%). The majority of women conceive spontaneously: 284 pregnancies with 173 live births. The most frequent pregnancy complication was miscarriage and chorioamnionitis. RT appears to be a safe option for eligible women who intend to maintain their future pregnancy desire.
Acta Chirurgica Latviensis, 2016
SummaryTraditionally the treatment for invasive cervical carcinoma which has progressed beyond micro invasion has been radical hysterectomy, unfortunately directly affecting fertility. Long term experience of radical surgery for Stage IB carcinoma has shown that it produces excellent results in terms of survival; however there is always a loss of potential for future fertility. Increasingly large numbers of young women (24-35 years) are being diagnosed with cervical cancer (7). Saving uterus where is safely possible is the main challenge to a surgeon as the loss of fertility for women can be devastating.Approximately one-third of infertility is attributed to the female partner, one-third attributed to the male partner and one-third is caused by a combination of problems in both partners.The incidence of a cervical cancer diagnosis in reproductive age women has increased in parallel to the quality in diagnostic in Latvia. However along with a scientifically evident knowledge, new sur...
Abdominal Radical Trachelectomy as a Method of Preserving Fertility in Patients with Cervical Cancer
2018
Cervical cancer is the 4th most common type of cancer in women across EU. However, in women of reproductive age, the incidence of this pathology is high, therefore, over the last decades various strategies have been developed with the purpose of preserving fertility in oncological patients. This paper aimed at reviewing the existing literature information regarding the use of abdominal radical trachelectomy as a method of fertility sparing treatment for patients with early invasive cervical cancer injuries, without neglecting to emphasize on the surgical, obstetrical and oncological outcomes of this procedure.
Pregnancy outcomes in patients after radical trachelectomy
American Journal of Obstetrics and Gynecology, 2003
OBJECTIVES: This study was undertaken to review and analyze the fertility and pregnancy outcomes in patients who have undergone radical trachelectomy as the method of management of invasive carcinoma of the cervix. STUDY DESIGN: All preoperative, operative, and follow-up data were collected prospectively. Perinatal information was completed by chart reviews and patient questionnaires. RESULTS: Of 80 patients having undergone the above procedure, 39 have attempted to conceive for a median of 11 months (range 1-85). There have been a total of 22 pregnancies in 18 patients (4 patients pregnant twice). Of the 22 pregnancies, 18 were viable, with 12 progressing to term and delivering by caesarean section. Preterm premature rupture of membranes was the primary cause of preterm delivery. CONCLUSION: This series confirms that pregnancy is a safe and realistic outcome for women undergoing radical trachelectomy for invasive carcinoma of the cervix. Given the apparently high incidence of preterm premature rupture of membranes, these pregnancies should be managed as high risk. (Am J Obstet Gynecol 2003;189:1378-82.)
BJOG: An International Journal of Obstetrics and Gynaecology, 2001
The recurrence and fertility rates in 30 women undergoing radical trachelectomy for early stage invasive cervical cancer at St Bartholomew's and Royal Marsden Hospital were reviewed. There were no recurrences, and the mean follow up was 23 months (range 1±64 months). Of 13 women trying to have a baby, eight had conceived with a total of 14 pregnancies and nine live births. Two were still trying and three were experiencing sub-fertility. There were seven premature deliveries and one late miscarriage. Six of the preterm births and the late miscarriage were associated with prelabour spontaneous rupture of membranes. This conservative yet locally radical procedure for a highly selected group of women who wished to preserve their fertility appears to offer a safe alternative to radical hysterectomy in early invasive cervical cancer.
SEA: Practical Application of Science, 2017
Radical trachelectomy is an established method of fertility sparing in female patients with early stage cervical cancer. This paper aims to review the series of obstetric and reproductive challenges that may arise following trachelectomy. Additionally, the article emphasized the pregnancy rates achieved after radical abdominal trachelectomy, as presented in studies conducted worldwide, since patients who undergo trachelectomy usually need assisted reproductive technologies to conceive and the pregnancy have a higher risk of preterm birth therefore, the patients should be monitored carefuly by a multidisciplinary team composed of obstetricians, neonatologists and oncologists. Cervical cancer is the second most common type of cancer affecting women of reproductive age. In women of reproductive age, cervical cancer is the second most common type of cancer diagnosed, however nowdays, women diagnosed in early stage who want to conceive children have the opportunity to do so due to the mi...
Journal of Health Science and Medical Research
A 31-year-old woman, gravida 0, was found to have atypical glandular cells on her cytology cervical smear. A colposcopy-directed biopsy revealed adenocarcinoma. Without a definite endocervical mass extension on a magnetic resonance imaging, a single-port-access laparoscopic radical trachelectomy (SPA-RT) was performed. The final pathology was adenocarcinoma with a free section margin. She resumed her normal menstrual cycle a month after the operation and a few months later became naturally pregnant, delivering a viable infant at 34 weeks of gestation by cesarean section. At the time of this writing, 64 months after the SPA-RT, she is still free from recurrent disease.