Abstract
Purpose
Radical trachelectomy (RT) with pelvic lymphadenectomy has become a new treatment option for young patients with uterine cervical cancer stages 1A2–1B1 who desire the preservation of their fertility. However, the application of RT for pregnant patients is still controversial. We comparatively studied both obstetrical and oncological outcomes of pregnant patients who underwent vaginal RT during pregnancy and those who underwent vaginal RT before pregnancy.
Methods
Both obstetrical and oncological results of eight patients who underwent vaginal RT with pelvic lymphadenectomy during pregnancy in our institute between 2010 and 2020 (Group A), and ten pregnant patients who underwent vaginal RT with pelvic lymphadenectomy before pregnancy during the same period (Group B) were reviewed based on their medical charts.
Results
There were neither significant differences in blood loss, surgical time, or surgical completeness between Group A and Group B, nor were there significant differences in obstetrical outcomes between the two groups. However, two of the eight patients in Group A had recurrence of the cancer. None of the patients in Group B has shown any signs of recurrence thus far.
Conclusion
Vaginal RT during pregnancy does not affect the obstetrical prognoses of patients with early invasive uterine cervical cancer, and it might be a tolerable treatment modality for them. However, oncologically, it should be performed carefully as there is a risk of recurrence.
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SS, SI, TM, and TS designed the research. All the authors attended the management of each patients as a treatment team. SS, YF, MK, and MS analyzed data. SI and TS supervised the research. SS, SI, and TS wrote the manuscript. All the authors have read and approved the manuscript.
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This study adhered to the tenets of Declaration of Helsinki, and the study design was reviewed and approved by the Sapporo medical university’s review board and the ethics committee (approval number:05–26). Permission to access and to use these data was also approved.
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Shinkai, S., Ishioka, S., Mariya, T. et al. Does radical trachelectomy (RT) during pregnancy have higher obstetrical and oncological risks than RT before pregnancy?. Arch Gynecol Obstet 306, 189–197 (2022). https://doi.org/10.1007/s00404-021-06327-w
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DOI: https://doi.org/10.1007/s00404-021-06327-w