Surgical and obstetrical outcomes after laparoscopic radical trachelectomy and pelvic lymphadenectomy for early cervical cancer
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
ObjectiveThe aim of this study was to evaluate the surgical and obstetrical outcomes of patients with early cervical cancer who underwent laparoscopic radical trachelectomy and pelvic lymphadenectomy. MethodsWe analyzed data from women who underwent laparoscopic radical trachelectomy and pelvic lymphadenectomy between July 2000 and October 2014. ResultsOf a total of 12 patients, 91.7% were FIGO (International Federation of Gynecology and Obstetrics) stages IA2 and IB1. Seven patients (58.3%) had squamous cell carcinoma. The median tumor size was 1.87 cm (range, focal to 4.6 cm) and two patients (16.7%) had a tumor lager than 2 cm. Lymphovascular space invasion in the tumor lesion was reported in six patients (50%). The following surgical complications were observed: neurogenic bladder (one patient), hemoperitoneum (one patient), and infection (one patient). A total of 33.3% had attempted to conceive, resulting in two pregnancies and two healthy babies. All pregnancies were achieved by in vitro fertilization and embryo transfer. Each woman underwent cesarean delivery because of premature pre-labor rupture of membranes at gestational weeks 27.3 and 33.3. After a median follow-up time of 4.4 years (range, 1 to 8 years), there were no recurrences or deaths. ConclusionLaparoscopic radical trachelectomy and pelvic lymphadenectomy should be offered as an alternative treatment for women with early stage cervical cancer who want to preserve their fertility.
Abstract
ObjectiveThe aim of this study was to evaluate the surgical and obstetrical outcomes of patients with early cervical cancer who underwent laparoscopic radical trachelectomy and pelvic lymphadenectomy. MethodsWe analyzed data from women who underwent laparoscopic radical trachelectomy and pelvic lymphadenectomy between July 2000 and October 2014. ResultsOf a total of 12 patients, 91.7% were FIGO (International Federation of Gynecology and Obstetrics) stages IA2 and IB1. Seven patients (58.3%) had squamous cell carcinoma. The median tumor size was 1.87 cm (range, focal to 4.6 cm) and two patients (16.7%) had a tumor lager than 2 cm. Lymphovascular space invasion in the tumor lesion was reported in six patients (50%). The following surgical complications were observed: neurogenic bladder (one patient), hemoperitoneum (one patient), and infection (one patient). A total of 33.3% had attempted to conceive, resulting in two pregnancies and two healthy babies. All pregnancies were achieved by in vitro fertilization and embryo transfer. Each woman underwent cesarean delivery because of premature pre-labor rupture of membranes at gestational weeks 27.3 and 33.3. After a median follow-up time of 4.4 years (range, 1 to 8 years), there were no recurrences or deaths. ConclusionLaparoscopic radical trachelectomy and pelvic lymphadenectomy should be offered as an alternative treatment for women with early stage cervical cancer who want to preserve their fertility.
참고문헌 (28)
- Siegel R, "Cancer statistics, 2014", CA Cancer J Clin, 64, pp.9~29 (2014)
- 정규원, "Cancer Statistics in Korea: Incidence, Mortality, Survival and Prevalence in 2010", Cancer Research and Treatment, 45(1), pp.1~14 (2013), 대한암학회[DOI]
- Young Hwa Lee, "Current status of the National Cancer Screening Program for cervical cancer in Korea, 2009", Journal of Gynecologic Oncology, 23(1), pp.16~21 (2012), 대한부인종양학회
- 정규원, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2012", Cancer Research and Treatment, 47(2), pp.127~141 (2015), 대한암학회[DOI]
- Quinn MA, "Carcinoma of the cervix uteri. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer", Int J Gynaecol Obstet, 95(Suppl 1), pp.S43~S103 (2006)
- Dargent D, "Pregnancies following radical trachelectomy for invasive cervical cancer", Gynecol Oncol, 54, pp.105~ (1994)
- Rob L, "Fertility-sparing surgery in patients with cervical cancer", Lancet Oncol, 12, pp.192~200 (2011)
- Plante M, "Vaginal radical trachelectomy: a valuable fertility-preserving option in the management of early-stage cervical cancer. A series of 50 pregnancies and review of the literature", Gynecol Oncol, 98, pp.3~10 (2005)
- Diaz JP, "Oncologic outcome of fertility-sparing radical trachelectomy versus radical hysterectomy for stage IB1 cervical carcinoma", Gynecol Oncol, 111, pp.255~260 (2008)
- Einstein MH, "Radical vaginal versus abdominal trachelectomy for stage IB1 cervical cancer : a comparison of surgical and pathologic outcomes", Gynecol Oncol, 112, pp.73~77 (2009)
- Kasamatsu T, "Prognostic significance of positive peritoneal cytology in adenocarcinoma of the uterine cervix", Gynecol Oncol, 115, pp.488~492 (2009)
- Shiho Kuji, "The relationship between positive peritoneal cytology and the prognosis of patients with FIGO stage I", II uterine cervical cancer, 2014, pp.25(2), 90~96[DOI]
- Sonoda Y, "A fertility-sparing alternative to radical hysterectomy: how many patients may be eligible?", Gynecol Oncol, 95, pp.534~538 (2004)
- Watson M, "Burden of cervical cancer in the United States, 1998-2003", Cancer, 113(10 Suppl), pp.2855~2864 (2003)
- Faber-Swensson AP, "Radical trachelectomy for early stage cervical cancer : the Queensland experience", Aust N Z J Obstet Gynaecol, 54, pp.450~452 (2014)
- Park JY, "Long-term outcomes after fertility-sparing laparoscopic radical trachelectomy in young women with early-stage cervical cancer : an Asan Gynecologic Cancer Group(AGCG)study", J Surg Oncol, 110, pp.252~257 (2014)
- Plante M, "Fertility-preserving options for cervical cancer", Oncology (Williston Park), 20, pp.479~488 (2006)
- Pareja R, "Surgical, oncological, and obstetrical outcomes after abdominal radical trachelectomy: a systematic literature review", Gynecol Oncol, 131, pp.77~82 (2013)
- Plante M, "The vaginal radical trachelectomy : an update of a series of 125 cases and 106 pregnancies", Gynecol Oncol, 121, pp.290~297 (2011)
- Kim JH, "Fertility-sparing laparoscopic radical trachelectomy for young women with early stage cervical cancer", BJOG, 117, pp.340~347 (2010)
- Chang SJ, "Uterine artery-preserving laparoscopic radical trachelectomy for early cervical cancer : technical aspects", Gynecol Oncol, 126, pp.277~278 (2012)
- Nam JH, "Comparative study of laparoscopico-vaginal radical hysterectomy and abdominal radical hysterectomy in patients with early cervical cancer", Gynecol Oncol, 92, pp.277~283 (2004)
- Kim CH, "Reproductive outcomes of patients undergoing radical trachelectomy for early-stage cervical cancer", Gynecol Oncol, 125, pp.585~588 (2012)
- Hauerberg L, "Vaginal Radical Trachelectomy for early stage cervical cancer : results of the Danish National Single Center Strategy", Gynecol Oncol, 138, pp.304~310 (2015)
- Lu Q, "Total laparoscopic radical trachelectomy in the treatment of early-stage cervical cancer : review of technique and outcomes", Curr Opin Obstet Gynecol, 26, pp.302~307 (2014)
- Cunningham FG, "Williams obstetrics", pp.829~861 (2014), McGraw-Hill
- Bernardini M, "Pregnancy outcomes in patients after radical trachelectomy", Am J Obstet Gynecol, 189, pp.1378~1382 (2003)
- Kim M, "Importance of uterine cervical cerclage to maintain a successful pregnancy for patients who undergo vaginal radical trachelectomy", Int J Clin Oncol, 19, pp.906~911 (2014)