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Lim YK, Chia YN, Quek SC, Yam KL
Correspondence: Dr Lim Yong Kuei Timothy, yongkuei@hotmail.com
ABSTRACT
We report the first case of radical abdominal trachelectomy (RAT) and bilateral pelvic lymphadenectomy performed in Singapore, which was performed for a 35-year-old woman with stage IB1 cervical cancer, and review the current literature on this novel fertility-sparing surgery. Radical hysterectomy and pelvic lymphadenectomy are the conventional treatment for stage IB1 cervical cancer, but this results in the loss of fertility. However, the last 20 years have seen the development of fertility-sparing surgeries for young women with early-stage cervical cancer. Among these, laparoscopy-assisted radical vaginal trachelectomy (i.e. Dargent’s procedure) is the most established technique, with good, documented long-term oncological and pregnancy outcomes. RAT, an alternative technique, was developed in the last decade. Although less than 200 reported cases worldwide have reported on the use of RAT, early data suggests good oncological outcome.
Keywords: abdominal radical trachelectomy, cervical cancer, fertility-sparing
Singapore Med J 2013; 54(10): e204–e207; http://dx.doi.org/10.11622/smedj.2013193
REFERENCES
| 1. Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet 2009; 105:103-4. http://dx.doi.org/10.1016/j.ijgo.2009.02.012 |
||||
| 2. Abu-Rustum NR, Sonoda Y, Black D, et al. Fertility-sparing radical abdominal trachelectomy for cervical carcinoma: technique and review of the literature. Gynecol Oncol 2006; 103:807-13. http://dx.doi.org/10.1016/j.ygyno.2006.05.044 |
||||
| 3. Dargent D, Brun JL, Roy M, Remi I. Pregnancies following radical trachelectomy for invasive cervical cancer. Gynecol Oncol 1994; 52:105. | ||||
| 4. Dargent D, Martin X, Sacchetoni A, Mathevet P. Laparoscopic vaginal trachelectomy a treatment to preserve the fertility of cervical carcinoma patients. Cancer 2000; 88:1877-82. http://dx.doi.org/10.1002/(SICI)1097-0142(20000415)88:8<1877::AID-CNCR17>3.0.CO;2-W |
||||
| 5. Shepherd JH, Spencer C, Herod J, Ind TE. Radical vaginal trachelectomy as a fertility-sparing procedure in women with early-stage cervical cancer-cumulative pregnancy rate in a series of 123 women. BJOG 2006; 113:719-24. http://dx.doi.org/10.1111/j.1471-0528.2006.00936.x |
||||
| 6. Rob L, Skapa P, Robova H. Fertility sparing surgery in patients with cervical cancer. Lancet Oncol 2011; 12:192-200. http://dx.doi.org/10.1016/S1470-2045(10)70084-X |
||||
| 7. Ungár L, Pálfalvi L, Hogg R, et al. Abdominal radical trachelectomy: a fertility-preserving option for women with early cervical cancer. BJOG 2005; 112:366-9. http://dx.doi.org/10.1111/j.1471-0528.2004.00421.x |
||||
| 8. Cibula D, Sláma J, Svárovský J, et al. Abdominal radical trachelectomy in fertility sparing treatment of early stages cervical cancer. Int J Gynecol Cancer 2009; 19:1407-11. http://dx.doi.org/10.1111/IGC.0b013e3181b9549a |
||||
| 9. Nishio H, Fujii T, Kameyama K, et al. Abdominal radical trachelectomy as a fertility sparing procedure in women with early stage cervical cancer in a series of 61 women. Gynaecol Oncol 2009; 115:51-5. http://dx.doi.org/10.1016/j.ygyno.2009.06.036 |
||||
| 10. Li J, Li Z, Wang, H et al. Radical abdominal trachelectomy for cervical malignancies: surgical, oncological and fertility outcomes in 62 patients. Gynecol Oncol 2011; 121:565-70. http://dx.doi.org/10.1016/j.ygyno.2011.01.032 |
||||
| 11. Pareja R, Ramirez PT, Borrero MF et al. Abdominal radical trachelectomy for invasive cervical cancer: A case series and literature review. Gynecol Oncol 2008; 111:438-43. http://dx.doi.org/10.1016/j.ygyno.2008.07.019 |
||||
| 12. Olawaiye A, Del Carmen M, Tambouret R, et al. Abdominal radical trachelectomy: Success and pitfalls in a general gynecologic oncology practice. Gynecol Oncol 2009; 112:506-10. http://dx.doi.org/10.1016/j.ygyno.2008.10.029 |
||||
| 13. Nick AM, Frumovitz MM, Soliman PT, Schmeler KM, Ramirez PT. Fertility sparing surgery for treatment of early stage cervical cancer: open vs. robotic radical trachelectomy. Gynecol Oncol 2012; 124:276-80. http://dx.doi.org/10.1016/j.ygyno.2011.09.035 |
||||
| 14. Kim JH, Park JY, Kim DY, et al. Fertility-sparing laparoscopic radical trachelectomy for young women with early stage cervical cancer. BJOG 2010; 117:340-7. http://dx.doi.org/10.1111/j.1471-0528.2009.02446.x |
||||
| 15. Maneo A, Chiari S, Bonazzi C, Mangioni C. Neoadjuvant chemotherapy and conservative surgery for stage IB1 cervical cancer. Gynecol Oncol 2007; 107:125-26. | ||||