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

Ekdahl, Linnea LU orcid ; Paraghamian, Sarah ; Eoh, Kyung Jin ; Thumuluru, Kavitha Madhuri ; Butler-Manuel, Simon A. ; Kim, Young Tae ; Boggess, John F. ; Persson, Jan LU and Falconer, Henrik (2022) In Gynecologic Oncology 164(3). p.529-534
Abstract

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 (7.2%) 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... (More)

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 (7.2%) 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 76 live 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.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cervical cancer, Long-term follow-up, Recurrence, Reproductive outcome, Robotic radical trachelectomy
in
Gynecologic Oncology
volume
164
issue
3
pages
6 pages
publisher
Academic Press
external identifiers
  • pmid:34980514
  • scopus:85122078517
ISSN
0090-8258
DOI
10.1016/j.ygyno.2021.12.029
language
English
LU publication?
yes
id
ee667989-b1bd-460f-b4e5-fd00d45d8852
date added to LUP
2022-03-03 14:40:45
date last changed
2025-04-19 22:28:25
@article{ee667989-b1bd-460f-b4e5-fd00d45d8852,
  abstract     = {{<p>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 (7.2%) 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 76 live 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.</p>}},
  author       = {{Ekdahl, Linnea and Paraghamian, Sarah and Eoh, Kyung Jin and Thumuluru, Kavitha Madhuri and Butler-Manuel, Simon A. and Kim, Young Tae and Boggess, John F. and Persson, Jan and Falconer, Henrik}},
  issn         = {{0090-8258}},
  keywords     = {{Cervical cancer; Long-term follow-up; Recurrence; Reproductive outcome; Robotic radical trachelectomy}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{529--534}},
  publisher    = {{Academic Press}},
  series       = {{Gynecologic Oncology}},
  title        = {{Long term oncologic and reproductive outcomes after robot-assisted radical trachelectomy for early-stage cervical cancer. An international multicenter study}},
  url          = {{http://dx.doi.org/10.1016/j.ygyno.2021.12.029}},
  doi          = {{10.1016/j.ygyno.2021.12.029}},
  volume       = {{164}},
  year         = {{2022}},
}