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Reproductive outcomes after laparoscopic radical trachelectomy for early-stage cervical cancer

Journal of Gynecologic Oncology 2014년 25권 1호 p.9 ~ p.13

박정열(Park Jeong-Yeol) - University of Ulsan College of Medicine Asan Medical Center Department of Obstetrics and Gynecology
김대연(Kim Dae-Yeon) - University of Ulsan College of Medicine Asan Medical Center Department of Obstetrics and Gynecology
서대식(Suh Dae-Shik) - University of Ulsan College of Medicine Asan Medical Center Department of Obstetrics and Gynecology
김종혁(Kim Jong-Hyeok) - University of Ulsan College of Medicine Asan Medical Center Department of Obstetrics and Gynecology
김용만(Kim Yong-Man) - University of Ulsan College of Medicine Asan Medical Center Department of Obstetrics and Gynecology
남주현(Nam Joo-Hyun) - University of Ulsan College of Medicine Asan Medical Center Department of Obstetrics and Gynecology
김영탁(Kim Young-Tak) - University of Ulsan College of Medicine Asan Medical Center Department of Obstetrics and Gynecology

Abstract

Objective: The objective of this study was to estimate the reproductive outcome of young women with early-stage cervical cancer who underwent fertility-sparing laparoscopic radical trachelectomy (LRT).

Methods: We performed a retrospective review of the medical records of patients with early-stage cervical cancer who underwent LRT. Clinicopathological data were obtained from patient medical records, and reproductive outcome data were obtained from patient medical records and telephone interviews.

Results: Fifty-five patients who underwent successful LRT were included in this study. The median age of patients was 32 years (range, 22 to 40 years), and the median follow-up time after LRT was 37 months (range, 3 to 105 months). Menstruation resumed in all patients after LRT, with fifty patients (90.9%) and five patients (9.1%) reporting regular and irregular menstruation, respectively. Six patients (10.9%) presented with cervical stenosis, which was manifested by regular but decreased menstrual flow and newly-developed dysmenorrhea. These patients underwent cervical cannulation and dilatation. Eighteen patients (32.7%) attempted to conceive, with six out of 18 patients receiving fertility treatments. Fourteen pregnancies (i.e., four missed abortions, six preterm births and four full-term births) occurred in 10 patients after LRT. Nine out of 10 patients gave birth to 10 healthy babies. The pregnancy rate after LRT was 55.6% (10/18). The spontaneous abortion rate and live birth rate were 28.6% (4/14) and 71.4% (10/14), respectively. The preterm birth rate was 60% (6/10).

Conclusion: Pregnancy and live birth rates after LRT were promising; however, the preterm birth rate was relatively high. Cervical stenosis also occurred in a small percentage of patients.