Academic Journal
Fertility-Sparing Surgery for Early Cervical Cancer-Approach to Less Radical Surgery
| العنوان: | Fertility-Sparing Surgery for Early Cervical Cancer-Approach to Less Radical Surgery |
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| المؤلفون: | Raju, Shanti Kankipati, Papadopoulos, Andreas John, Montalto, Stephen Attard, Coutts, Michael, Culora, Guiseppe, Kodampur, Malik, Mehra, Gautam, Devaja, Omer |
| المصدر: | Raju , S K , Papadopoulos , A J , Montalto , S A , Coutts , M , Culora , G , Kodampur , M , Mehra , G & Devaja , O 2012 , ' Fertility-Sparing Surgery for Early Cervical Cancer-Approach to Less Radical Surgery ' , INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER , vol. 22 , no. 2 , pp. 311-317 . https://doi.org/10.1097/IGC.0b013e3182370f51 |
| سنة النشر: | 2012 |
| المجموعة: | King's College, London: Research Portal |
| مصطلحات موضوعية: | Trachelectomy, Pregnancy, Fertility, Cervical cancer, OF-THE-LITERATURE, MICROINVASIVE CARCINOMA, HYSTERECTOMY, WOMEN, PARAMETRECTOMY, INVOLVEMENT, OUTCOMES, SERIES |
| الوصف: | Objective: To evaluate whether certain patients with early-stage cervical cancer are candidates for less radical surgery when considering fertility-sparing surgery. Design: Prospective cohort study. Setting: Two gynecologic cancer centers (St Thomas' Hospital, London; and West Kent Gynaecological Cancer Centre, Maidstone). Population: Women with early-stage cervical cancer (n = 66) undergoing fertility-sparing surgery, either simple (SVT) or radical vaginal trachelectomy (RVT). Methods: Prospective clinical data collection and review of patient notes, pathology and radiology data, and pregnancy outcomes. Main Outcome Measures: Postoperative complications, surgical specimen histologic analysis, follow-up data, and obstetric outcome. Results: A total of 66 women underwent either SVT (n = 15) or RVT (n = 51), with pelvic lymphadenectomy, for stage IA2 or IB1 cervical cancer. There was no residual disease in the SVT specimen in 53% versus 29% after RVT. Clear surgical margins in 100% of SVT specimens with residual disease versus 94% after RVT. Two patients had positive lymph nodes after RVT; one of these declined adjuvant treatment until after egg harvesting and subsequently died of disease (1.5%). Median follow-up was 96 months (range, 12-120 months). One patient had a mid vaginal recurrence (1.5%). Twenty-four women have tried to conceive to date, with 14 women having 17 live births. Live birth pregnancy rate was 70.8%. Conclusions: It is possible to select patients for a less radical fertility-sparing procedure through identification of measurable low-risk factors and thus reduce the morbidity caused by conventional RVT. The selection criteria should be stringent and applied within the setting of a cancer center. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1097/IGC.0b013e3182370f51 |
| الاتاحة: | https://kclpure.kcl.ac.uk/portal/en/publications/acbbe32f-f839-47dc-a06c-7cf906b3bf42 https://doi.org/10.1097/IGC.0b013e3182370f51 |
| Rights: | info:eu-repo/semantics/restrictedAccess |
| رقم الانضمام: | edsbas.E0C97760 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1097/IGC.0b013e3182370f51 |
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