Research Progress of Radical Trachelectomy for Early Stage Cervical Cancer

doi:10.12280/gjfckx.20220098

Abstract

Abstract:

Cervical cancer is one of the most common gynecological malignant tumors. With the trend of younger age of cervical cancer, more and more patients have the requirement of sparing fertility. Radical trachelectomy has become the standard surgical method for preserving reproductive function in patients with International Federation of Gynecology and Obstetrics （FIGO） stage ⅠA2 and ⅠB1 cervical cancer,and has also been applied in patients with cervical cancer with tumor diameter >2 cm after neoadjuvant chemo therapy and patients with pregnancy complicated with cervical cancer. Radical trachelectomy has a large operation scope, great difficulty, long operation time and high incidence of postoperative complications. Surgical approach, intraoperative technique and the way of lymph node evaluation may have different effects on tumor prognosis and pregnancy outcome. Therefore, seeking a balance between tumor prognosis and reproductive function after radical trachelectomy, reducing unnecessary tissue resection and injury while ensuring tumor resection scope, shortening operation time and reducing the probability of complications can benefit more cervical cancer patients undergoing radical trachelectomy.

Key words: Uterine cervical neoplasms, Hysterectomy, Laparoscopy, Pregnancy outcome, Prognosis

CHEN Yue, LI Na, HU Yuan-jing. Research Progress of Radical Trachelectomy for Early Stage Cervical Cancer[J]. Journal of International Obstetrics and Gynecology, 2022, 49(5): 524-528.

References 27

[1]	Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries[J]. CA Cancer J Clin, 2021, 71(3):209-249. doi: 10.3322/caac.21660. doi: 10.3322/caac.21660
[2]	Li S, Hu T, Lv W, et al. Changes in prevalence and clinical characteristics of cervical cancer in the People′s Republic of China: a study of 10,012 cases from a nationwide working group[J]. Oncologist, 2013, 18(10):1101-1107. doi: 10.1634/theoncologist.2013-0123. doi: 10.1634/theoncologist.2013-0123
[3]	Cottrell CM, Ohaegbulam GC, Smith JR, et al. Fertility-sparing treatment in cervical cancer: Abdominal trachelectomy[J]. Best Pract Res Clin Obstet Gynaecol, 2021, 75:72-81. doi: 10.1016/j.bpobgyn.2021.01.011. doi: 10.1016/j.bpobgyn.2021.01.011 pmid: 33846052
[4]	Ind T. Radical vaginal trachelectomy[J]. Best Pract Res Clin Obstet Gynaecol, 2021, 75:65-71. doi: 10.1016/j.bpobgyn.2021.04.005. doi: 10.1016/j.bpobgyn.2021.04.005 pmid: 34099413
[5]	Marchiole P, Benchaib M, Buenerd A, et al. Oncological safety of laparoscopic-assisted vaginal radical trachelectomy (LARVT or Dargent′s operation): A comparative study with laparoscopic-assisted vaginal radical hysterectomy (LARVH)[J]. Gynecol Oncol, 2007, 106(1):132-141. doi: 10.1016/j.ygyno.2007.03.009. doi: 10.1016/j.ygyno.2007.03.009
[6]	Rizzuto I, Macnab W, Nicholson R, et al. Less radical surgery for women with early stage cervical cancer: Our experience on radical vaginal trachelectomy and laparoscopic pelvic lymphadenectomy[J]. Gynecol Oncol Rep, 2019, 28:65-67. doi: 10.1016/j.gore.2019.03.005. doi: 10.1016/j.gore.2019.03.005
[7]	Li X, Li J, Jiang Z, et al. Oncological results and recurrent risk factors following abdominal radical trachelectomy: an updated series of 333 patients[J]. BJOG, 2019, 126(9):1169-1174. doi: 10.1111/1471-0528.15621. doi: 10.1111/1471-0528.15621
[8]	Li X, Xia L, Li J, et al. Reproductive and obstetric outcomes after abdominal radical trachelectomy (ART) for patients with early-stage cervical cancers in Fudan, China[J]. Gynecol Oncol, 2020, 157(2):418-422. doi: 10.1016/j.ygyno.2020.02.016. doi: S0090-8258(20)30152-9 pmid: 32122687
[9]	Prodromidou A, Iavazzo C, Fotiou A, et al. Short- and long term outcomes after abdominal radical trachelectomy versus radical hysterectomy for early stage cervical cancer: a systematic review of the literature and meta-analysis[J]. Arch Gynecol Obstet, 2019, 300(1):25-31. doi: 10.1007/s00404-019-05176-y. doi: 10.1007/s00404-019-05176-y pmid: 31062151
[10]	Guo J, Zhang Y, Chen X, et al. Surgical and oncologic outcomes of radical abdominal trachelectomy versus hysterectomy for stage IA2-IB1 cervical cancer[J]. J Minim Invasive Gynecol, 2019, 26(3):484-491. doi: 10.1016/j.jmig.2018.06.006. doi: 10.1016/j.jmig.2018.06.006
[11]	Ramirez PT, Frumovitz M, Pareja R, et al. Minimally Invasive versus Abdominal Radical Hysterectomy for Cervical Cancer[J]. N Engl J Med, 2018, 379(20):1895-1904. doi: 10.1056/NEJMoa1806395. doi: 10.1056/NEJMoa1806395
[12]	Lu Q, Zhang Z, Xiao M, et al. The Surgical Morbidity And Oncological Outcome Of Total Laparoscopic Radical Trachelectomy Versus Total Laparoscopic Radical Hysterectomy For Early Stage Cervical Cancer: A Retrospective Study With 11-Year Follow-Up[J]. Onco Targets Ther, 2019, 12:7941-7947. doi: 10.2147/OTT.S224525. doi: 10.2147/OTT.S224525
[13]	Salvo G, Ramirez PT, Leitao MM, et al. Open vs minimally invasive radical trachelectomy in early-stage cervical cancer: International Radical Trachelectomy Assessment Study[J]. Am J Obstet Gynecol, 2022, 226(1):97.e1-e16. doi: 10.1016/j.ajog.2021.08.029. doi: 10.1016/j.ajog.2021.08.029
[14]	Kanao H, Aoki Y, Fusegi A, et al. Feasibility and Outcomes of “No-Look No-Touch” Laparoscopic Radical Trachelectomy for Early-Stage Cervical Cancer[J]. J Clin Med, 2021, 10(18):4154. doi: 10.3390/jcm10184154. doi: 10.3390/jcm10184154
[15]	Johansen G, Lönnerfors C, Falconer H, et al. Reproductive and oncologic outcome following robot-assisted laparoscopic radical trachelectomy for early stage cervical cancer[J]. Gynecol Oncol, 2016, 141(1):160-165. doi: 10.1016/j.ygyno.2016.01.028. doi: 10.1016/j.ygyno.2016.01.028 pmid: 26845228
[16]	Kasuga Y, Ikenoue S, Tanaka M, et al. Management of pregnancy after radical trachelectomy[J]. Gynecol Oncol, 2021, 162(1):220-225. doi: 10.1016/j.ygyno.2021.04.023. doi: 10.1016/j.ygyno.2021.04.023 pmid: 33902946
[17]	Kasuga Y, Miyakoshi K, Nishio H, et al. Mid-trimester residual cervical length and the risk of preterm birth in pregnancies after abdominal radical trachelectomy: a retrospective analysis[J]. BJOG, 2017, 124(11):1729-1735. doi: 10.1111/1471-0528.14688. doi: 10.1111/1471-0528.14688
[18]	Harano N, Sakamoto M, Fukushima S, et al. Clinical Study of Sentinel Lymph Node Detection Using Photodynamic Eye for Abdominal Radical Trachelectomy[J]. Curr Oncol, 2021, 28(6):4709-4720. doi: 10.3390/curroncol28060397. doi: 10.3390/curroncol28060397 pmid: 34898550
[19]	Kim S, Chung S, Azodi M, et al. Uterine Artery-sparing Minimally Invasive Radical Trachelectomy: A Case Report and Review of the Literature[J]. J Minim Invasive Gynecol, 2019, 26(7):1389-1395. doi: 10.1016/j.jmig.2019.05.017. doi: 10.1016/j.jmig.2019.05.017
[20]	Bentivegna E, Gouy S, Maulard A, et al. Oncological outcomes after fertility-sparing surgery for cervical cancer: a systematic review[J]. Lancet Oncol, 2016, 17(6):e240-e253. doi: 10.1016/S1470-2045(16)30032-8. doi: 10.1016/S1470-2045(16)30032-8 pmid: 27299280
[21]	Park JY, Kim DY, Kim JH, et al. Outcomes after radical hysterectomy according to tumor size divided by 2-cm interval in patients with early cervical cancer[J]. Ann Oncol, 2011, 22(1):59-67. doi: 10.1093/annonc/mdq321. doi: S0923-7534(19)37783-X pmid: 20595451
[22]	Tesfai FM, Kroep JR, Gaarenstroom K, et al. Fertility-sparing surgery of cervical cancer >2 cm (International Federation of Gynecology and Obstetrics 2009 stage ⅠB1-ⅡA) after neoadjuvant chemotherapy[J]. Int J Gynecol Cancer, 2020, 30(1):115-121. doi: 10.1136/ijgc-2019-000647. doi: 10.1136/ijgc-2019-000647
[23]	Zusterzeel PLM, Aarts JWM, Pol FJM, et al. Neoadjuvant Chemotherapy Followed by Vaginal Radical Trachelectomy as Fertility-Preserving Treatment for Patients with FIGO 2018 Stage 1B2 Cervical Cancer[J]. Oncologist, 2020, 25(7):e1051-e1059. doi: 10.1634/theoncologist.2020-0063. doi: 10.1634/theoncologist.2020-0063
[24]	van Kol KGG, Vergeldt TFM, Bekkers RLM. Abdominal radical trachelectomy versus chemotherapy followed by vaginal radical trachelectomy in stage 1B2 (FIGO 2018) cervical cancer. A systematic review on fertility and recurrence rates[J]. Gynecol Oncol,2019, 155(3):515-521. doi: 10.1016/j.ygyno.2019.09.025. doi: 10.1016/j.ygyno.2019.09.025
[25]	Smith LH, Dalrymple JL, Leiserowitz GS, et al. Obstetrical deliveries associated with maternal malignancy in California, 1992 through 1997[J]. Am J Obstet Gynecol, 2001, 184(7):1504-1512;discussion 1512-1513. doi: 10.1067/mob.2001.114867. doi: 10.1067/mob.2001.114867 pmid: 11408874
[26]	Umemoto M, Ishioka S, Mizugaki Y, et al. Obstetrical prognosis of patients who underwent vaginal radical trachelectomy during pregnancy[J]. J Obstet Gynaecol Res, 2019, 45(6):1167-1172. doi: 10.1111/jog.13964. doi: 10.1111/jog.13964
[27]	Stanca M, Ciobanu V, Gheorghe M, et al. The Double Life-Saving Approach of Abdominal Radical Trachelectomy during Pregnancy for Early-Stage Cervical Cancer—An Overview of the Literature and Our Institutional Experience[J]. J Pers Med, 2021, 11(1):29. doi: 10.3390/jpm11010029. doi: 10.3390/jpm11010029