Long-term outcomes after fertility-sparing laparoscopic radical trachelectomy in young women with early-stage cervical cancer: an Asan Gynecologic Cancer Group (AGCG) study.

Abstract

OBJECTIVES: To evaluate the long-term outcomes and risk factors for recurrence

after fertility-sparing laparoscopic radical trachelectomy (LRT) in young women

with early-stage cervical cancer. METHODS: Eighty-eight consecutive patients from

four tertiary cancer centers in Korea who had attempted fertility-sparing LRT for

early-stage cervical cancer were included in this study. RESULTS: Seventy-nine

patients completed LRT. The mean age and tumor size were 31 years (range, 20-40

years) and 1.8 cm (range, 0.4-7 cm), respectively. Twenty-nine patients had a

tumor size greater than 2 cm, 22 had deep stromal invasion greater than 50%, and

twelve had lymphovascular space invasion. After a median follow-up time of 44

months (range, 3-105 months), nine patients had recurrence and one had died of

disease. A tumor size greater than 2 cm (P = 0.039) and a depth of stromal

invasion greater than 50% (P = 0.016) were significant risk factors for

recurrence. CONCLUSIONS: This is the largest series on fertility-sparing LRT in

young women with early cervical cancer. LRT is a feasible and safe

fertility-sparing alternative to radical hysterectomy in these women. A tumor

size greater than 2 cm and a depth of stromal invasion greater than 50% were risk

factors for recurrence.