Radical vaginal trachelectomy vs. radical hysterectomy for small early stage cervical cancer: A matched case-control study

M. E. Beiner, J. Hauspy, B. Rosen, J. Murphy, S. Laframboise, S. Nofech-Mozes, N. Ismiil, G. Rasty, M. A. Khalifa, A. Covens

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90 Scopus citations

Abstract

Objective: To determine the efficacy and outcome from radical vaginal trachelectomy (RVT) compared to a matched group of patients undergoing radical hysterectomy for small early stage cervical cancer. Methods: All patient data were entered prospectively. Patients wishing preservation of fertility with cervical cancer, tumor < 2 cm, and not meeting the definition of microinvasive cancer were offered RVT. The outcomes were compared to a matched group of patients who underwent radical hysterectomy for stage IA/IB cervical cancer. Groups were matched 1:1 for age (± 5 years), tumor size (± 1 mm), histology, grade, depth of invasion (± 1 mm), presence of capillary lymphatic space invasion, pelvic lymph node metastasis, and adjuvant radiotherapy. Results: A total of 137 patients underwent RVT between 1994 and 2007. Of them, 90 patients were successfully matched. Median tumor size was microscopic. Moreover, 43% and 49% were squamous and had adeno/adenosquamous histology. Median depth of invasion was 3.1 mm. Capillary lymphatic space invasion was present in 68% of cases. Of the tumors, 60% were grade 1, 29% were grade 2, and 11% were grade 3. After a median follow-up of 51 and 58 months, 5 and 1 recurrences were diagnosed in the RVT and radical hysterectomy groups, respectively. Five-year recurrence-free survival rates were present in 95% and 100% of the groups, respectively (p = 0.17). In addition, 3 and 1 deaths occurred in the RVT and radical hysterectomy groups, resulting in 5-year survival rates of 99% and 100%, respectively (p = 0.55). Conclusions: RVT seems to be the procedure of choice for women with small early stage cervical cancers wishing to preserve fertility.

Original languageEnglish (US)
Pages (from-to)168-171
Number of pages4
JournalGynecologic oncology
Volume110
Issue number2
DOIs
StatePublished - Aug 1 2008
Externally publishedYes

Keywords

  • Cervical cancer
  • Fertility preservation
  • Radical surgery

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    Beiner, M. E., Hauspy, J., Rosen, B., Murphy, J., Laframboise, S., Nofech-Mozes, S., Ismiil, N., Rasty, G., Khalifa, M. A., & Covens, A. (2008). Radical vaginal trachelectomy vs. radical hysterectomy for small early stage cervical cancer: A matched case-control study. Gynecologic oncology, 110(2), 168-171. https://doi.org/10.1016/j.ygyno.2008.04.027