Fertility-sparing laparoscopic radical trachelectomy for young women with early stage cervical cancer.

OBJECTIVE: To report the results of laparoscopic radical trachelectomy (LRT) with respect to surgical, oncological and reproductive outcomes.

DESIGN: Retrospective analysis.

SETTING: University of Ulsan College of Medicine, Asan Medical Centre, Seoul, Korea.

SAMPLE: Thirty-two consecutive patients who wish to preserve fertility with early stage cervical cancer.

METHODS: Demographic, clinicopathologic, surgical, and follow-up data were obtained from patients' medical records. All patients agreed to telephone interviews to assess their menstrual and obstetrical outcomes.

MAIN OUTCOME MEASURES: Surgical parameters, perioperative complication, disease-free survival, overall survival, return and pattern of menstruation and pregnancy rate.

RESULTS: Thirty-two consecutive patients who wish to preserve fertility with early stage cervical cancer were offered LRT. In five patients, the planned LRT procedures were abandoned during the operations because of lymph node metastasis or parametrial involvement on frozen section. The mean age was 29 years (range, 22-37 years). The mean tumour size was 1.7 cm in diameter (range, 0.4-3.5 cm). The mean operating time was 290 min (range, 120-520 min) and the mean estimated blood loss was 332 ml (range, 50-1000 ml). Perioperative transfusion was required in six patients. There were no perioperative complications requiring further management. After a median follow-up time of 31 months (range, 1-58 months), there was one recurrence and death from disease. Regular menstruation returned in 24 patients. Six patients attempted to conceive, and three succeeded.

CONCLUSIONS: Laparoscopic radical trachelectomy may be a safe and useful alternative to radical hysterectomy for women with early cervical cancer who want to preserve their fertility.