Abdominal radical trachelectomy in West London

Area of Science:

• Gynecologic Oncology
• Reproductive Medicine
• Surgical Oncology

Background:

• Radical abdominal hysterectomy is the traditional treatment for invasive cervical carcinoma, leading to infertility.
• Young women diagnosed with early-stage cervical cancer face fertility loss with standard surgical management.
• There is a need for fertility-sparing surgical options in gynecologic oncology.

Purpose of the Study:

• To evaluate abdominal radical trachelectomy (ART) as a fertility-sparing alternative to radical hysterectomy.
• To assess the oncologic safety and reproductive outcomes of ART for stage IA2-IIA cervical cancer.
• To determine the feasibility and effectiveness of ART in preserving curative rates while maintaining fertility.

Main Methods:

• Retrospective observational study of patients undergoing ART between 2000-2009.
• Selection of ART based on patient anatomy and tumor characteristics (MRI).
• Monitoring of survival, recurrence rates, and fertility outcomes post-ART.

Main Results:

• 30 patients underwent ART (open and laparoscopic) with a median follow-up of 24 months.
• Three patients experienced recurrence, with two deaths.
• Ten patients attempted conception, resulting in three pregnancies and two live births.

Conclusions:

• Abdominal radical trachelectomy is a feasible and safe treatment for early-stage cervical cancer in women desiring fertility preservation.
• ART offers a viable option to maintain oncologic control without compromising fertility.
• The procedure demonstrates acceptable complication rates and successful reproductive outcomes.