Long term oncologic and reproductive outcomes after robot-assisted radical trachelectomy for early-stage cervical cancer. An international multicenter study

被引:13
作者
Ekdahl, Linnea [1 ,6 ]
Paraghamian, Sarah [2 ]
Eoh, Kyung Jin [3 ]
Thumuluru, Kavitha Madhuri [4 ]
Butler-Manuel, Simon A. [4 ]
Kim, Young Tae [3 ]
Boggess, John F. [2 ]
Persson, Jan [1 ,6 ]
Falconer, Henrik [5 ]
机构
[1] Skane Univ Hosp, Dept Obstet & Gynecol, Div Gynecol Oncol, S-22185 Lund, Sweden
[2] Univ N Carolina, Dept Obstet & Gynecol, Chapel Hill, NC 27599 USA
[3] Yonsei Univ, Coll Med, Dept Obstet & Gynecol, CPO Box 8044, Seoul 120752, South Korea
[4] Royal Surrey NHS Fdn Trust, Dept Gynaecol Oncol, Great Britain, England
[5] Karolinska Univ Hosp, Theme Canc, Dept Pelv Canc, Karolinska Inst,Dept Womens & Childrens Hlth, Stockholm, Sweden
[6] Lund Univ, Fac Med, Clin Sci Obstet & Gynecol, S-22185 Lund, Sweden
关键词
Cervical cancer; Robotic radical trachelectomy; Long-term follow-up; Recurrence; Reproductive outcome; FERTILITY-SPARING SURGERY; CARCINOMA; HYSTERECTOMY; RISK;
D O I
10.1016/j.ygyno.2021.12.029
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objectives. Long term outcomes following fertility sparing robot-assisted radical trachelectomy (RRT). Methods. A retrospective study of consecutive women selected for RRT between 2007 and 2019 at five referral centres. Generally used selection criteria for fertility-sparing surgery were applied. Oncologic, reproductive and long-term clinical data were analysed. Results. Of the 166 included women, 149 completed a RRT. Median tumor size was 9 mm (range 3-20 mm), 111 women (75%) had FIGO 2009 stage IB1 cancer and 4.8% were node positive. At a median follow up of 58 months, 12 of all women (72%) and 9 of 149 women (6%) who underwent completed RRT with fertility preservation had recurred and two had died. 70 of 88 women (80%) who attempted to conceive succeeded, resulting in 81 pregnancies that progressed beyond the first trimester and 76live births of which 54 (70%) were delivered at term and 65 (86%) delivered after gestational week 32. A short postoperative cervical length was associated with impaired fertility. A late secondary hysterectomy was necessary in four women due to persistent bleeding (n - 2), hematometra due to a cervical stenosis (n = 1) and recurrent dysplasia (n = 1). Conclusion. In this long-term follow-up of RRT the recurrence rate is comparable to larger individual studies of minimally invasive or vaginal radical trachelectomy with similar risk profile and follow up. The high pregnancy rate and low rate of premature delivery before 32 weeks GA may promote the use of robot-assisted approach. (C) 2022 The Authors. Published by Elsevier Inc.
引用
收藏
页码:529 / 534
页数:6
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