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Important Factors of Successful Pregnancies and Deliveries After Abdominal Radical Trachelectomy for Early-stage Cervical Cancer; Single-institution Experience

Received: 29 November 2021    Accepted: 14 December 2021    Published: 24 December 2021
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Abstract

We assessed pregnancies and deliveries after abdominal radical trachelectomy (ART) based on reproductive outcomes. We retrospectively analyzed patients undergoing ART in our hospital from 2011 to 2020. Twenty-one patients (median age, 35 [range 27-40] years) with histologically diagnosed cervical cancer (squamous cell carcinoma [n=16], adenocarcinoma [n=4] and adenosquamous carcinoma [n=1]) underwent ART. Clinical stages (FIGO 2018) were IA1 (n=2), IA2 (n=5) and IB1 (n=14). Median follow-up period was 49 (1-108) months with no post-ART recurrence. Among 10 patients with post-ART planned pregnancies, 6 patients had pregnancies. Although all patients in the pregnancy group had pregnancies at the first fertility treatment, none of patients in the non-pregnancy group had pregnancies after several fertility treatment. Age, period after ART and the rate of bilateral uterine arteries preservation showed no significant difference between the pregnancy and non-pregnancy groups. Residual cervical length was about 10 mm in the pre-term delivery group and over 20 mm in the full-term delivery group. Age, fertility treatment and score of normal bacteria flora of the vagina showed no significant difference between pre-term delivery group and full-term delivery group. Bilateral uterine arteries preservation in the ART procedures were not associated with pregnancies after ART. Residual cervical length was associated with gestational age at delivery.

Published in Journal of Gynecology and Obstetrics (Volume 9, Issue 6)
DOI 10.11648/j.jgo.20210906.20
Page(s) 243-246
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Abdominal Radical Trachelectomy, Cervical Cancer, Uterine Artery, Residual Cervical Length

References
[1] Makino H, Kato H, Furui T, Hayasaki Y, Morishige K, Kanematsu M. Assessment of uterine enhancement rate after abdominal radical trachelectomy using dynamic contrast-enhanced magnetic resonance imaging. Archives of Gynecology and Obstetrics. Vol. 293, No. 3, 2016, pp. 625-632.
[2] Dargent D, Brun JL, Roy M, Remi I. Pregnancies following radical trachelectomy for invasive cervical cancer. Gynecologic Oncology. Vol. 54, 1994, pp. 105.
[3] Covens A, Shaw P, Murphy J, DePetrillo D, Lickrish G, Laframboise S, Rosen B. Is radical trachelectomy a safe alternative to radical hysterectomy for patients with stage IA-B carcinoma of the cervix? Cancer. Vol. 86, No. 11, 1999, pp. 2273-2279.
[4] Shepherd JH, Mould T, Oram DH. Radical trachelectomy in early stage carcinoma of the cervix: outcome as judged by recurrence and fertility rates. British Journal of Obstetrics and Gynaecology. Vol. 108, No. 8, 2001, pp. 882-885.
[5] Plante M, Renaud MC, Francois H, Roy M. Vaginal radical rachelectomy: an oncologically safe fertility-preserving surgery. An updated series of 72 cases and review of the literature. Gynecologic oncology. Vol. 94, No. 3, 2004, pp. 614-623.
[6] Burnett AF, Roman LD, O’Meara AT, Morrow CP. Radical vaginal trachelectomy and pelvic lymphadenectomy for preservation of fertility in early cervical carcinoma. Gynecologic oncology. Vol. 88, No. 3, 2003, pp. 419-423.
[7] Yi-feng W, Li Li Feng-hua L, Jing S, Ma S, Ying T, Chun-lin C. Modified abdominal radical trachelectomy for treatment of cervical carcinomas. Zhonghua Fu Chan Ke Za Zhi. Vol. 41, No. 4, 2006, pp. 226-228.
[8] Smith JR, Boyle DCM, Corless DJ, Ungar L, Lawson AD, Del Priore G, McCall JM, Lindsay I, Bridges JE. Abdominal radical trachelectomy: a new surgical technique for the conservative management of cervical carcinoma. British Journal of Obstetrics and Gynaecology. Vol. 104, No. 10, 1997, pp. 1196-1200.
[9] Rodriguez M, Guimares O, Rose PG. Radical abdominal trachelectomy and pelvic lymphadenectomy with uterine conservation and subsequent pregnancy in the treatment of early invasive cervical cancer. American Journal of Obstetrics and Gynecology. Vol. 185, No. 2, 2001, pp. 370-374.
[10] Pareja R, Rendón GJ, Sanz-Lomana CM, Monzón O, Ramirez PT. Surgical, oncological, and obstetrical outcomes after abdominal radical trachelectomy - a systematic literature review. Gynecologic Oncology. Vol. 13, No. 1, 2013, pp. 77-82.
[11] Svare JA, Andersen LF, Langhoff-Roos J, Jensen ET, Bruun B, Lind I, Madsen H. The relationship between prior cervical conization, cervical microbial colonization and preterm premature rupture of the membranes. European Journal of Obstetrics, Gynecology, and Reproductive Biology. Vol. 47, No. 1, 1992, pp. 41-45.
[12] Freitas AC, Chaban B, Bocking A, Rocco M, Yang S, Hill JE, Money DM, VOGUE Research Group. The vaginal microbiome of pregnant women is less rich and diverse, with lower prevalence of Mollicutes, compared to non-pregnant women. Scientific Reports. Vol. 23, No. 1, 2017, pp. 9212.
[13] Kasuga Y, Miyakoshi K, Nishio H, Akiba Y, Otani T, Fukutake M, Ikenoue S, Ochiai D, Matsumoto T, Tanaka K, Minegishi K, Kuji N, Roberts R, Aoki D, Tanaka M. Mid-trimester residual cervical length and the risk of preterm birth in pregnancies after abdominal radical trachelectomy: a retrospective analysis. British Journal of Obstetrics and Gynaecology. Vol. 124, No. 11, 2017, pp. 1729-1735.
[14] Rob L, Charvat M, Robova H, Pluta M, Strnad P, Hrehorcak M, Skapa P. Less radical fertility-sparing surgery than radical trachelectomy in early cervical cancer. International Journal of Gynecological Cancer. Vol. 17, No. 1, 2007, pp. 304-310.
[15] Milliken DA, Shepherd JH. Fertility preserving surgery for carcinoma of the cervix. Current Opinion in Oncology. Vol. 20, No. 5, 2008, pp. 575-580.
Cite This Article
  • APA Style

    Motoki Takenaka, Tatsuro Furui, Noriko Suzuki, Ken-Ichirou Morishige. (2021). Important Factors of Successful Pregnancies and Deliveries After Abdominal Radical Trachelectomy for Early-stage Cervical Cancer; Single-institution Experience. Journal of Gynecology and Obstetrics, 9(6), 243-246. https://doi.org/10.11648/j.jgo.20210906.20

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    ACS Style

    Motoki Takenaka; Tatsuro Furui; Noriko Suzuki; Ken-Ichirou Morishige. Important Factors of Successful Pregnancies and Deliveries After Abdominal Radical Trachelectomy for Early-stage Cervical Cancer; Single-institution Experience. J. Gynecol. Obstet. 2021, 9(6), 243-246. doi: 10.11648/j.jgo.20210906.20

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    AMA Style

    Motoki Takenaka, Tatsuro Furui, Noriko Suzuki, Ken-Ichirou Morishige. Important Factors of Successful Pregnancies and Deliveries After Abdominal Radical Trachelectomy for Early-stage Cervical Cancer; Single-institution Experience. J Gynecol Obstet. 2021;9(6):243-246. doi: 10.11648/j.jgo.20210906.20

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  • @article{10.11648/j.jgo.20210906.20,
      author = {Motoki Takenaka and Tatsuro Furui and Noriko Suzuki and Ken-Ichirou Morishige},
      title = {Important Factors of Successful Pregnancies and Deliveries After Abdominal Radical Trachelectomy for Early-stage Cervical Cancer; Single-institution Experience},
      journal = {Journal of Gynecology and Obstetrics},
      volume = {9},
      number = {6},
      pages = {243-246},
      doi = {10.11648/j.jgo.20210906.20},
      url = {https://doi.org/10.11648/j.jgo.20210906.20},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20210906.20},
      abstract = {We assessed pregnancies and deliveries after abdominal radical trachelectomy (ART) based on reproductive outcomes. We retrospectively analyzed patients undergoing ART in our hospital from 2011 to 2020. Twenty-one patients (median age, 35 [range 27-40] years) with histologically diagnosed cervical cancer (squamous cell carcinoma [n=16], adenocarcinoma [n=4] and adenosquamous carcinoma [n=1]) underwent ART. Clinical stages (FIGO 2018) were IA1 (n=2), IA2 (n=5) and IB1 (n=14). Median follow-up period was 49 (1-108) months with no post-ART recurrence. Among 10 patients with post-ART planned pregnancies, 6 patients had pregnancies. Although all patients in the pregnancy group had pregnancies at the first fertility treatment, none of patients in the non-pregnancy group had pregnancies after several fertility treatment. Age, period after ART and the rate of bilateral uterine arteries preservation showed no significant difference between the pregnancy and non-pregnancy groups. Residual cervical length was about 10 mm in the pre-term delivery group and over 20 mm in the full-term delivery group. Age, fertility treatment and score of normal bacteria flora of the vagina showed no significant difference between pre-term delivery group and full-term delivery group. Bilateral uterine arteries preservation in the ART procedures were not associated with pregnancies after ART. Residual cervical length was associated with gestational age at delivery.},
     year = {2021}
    }
    

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    T1  - Important Factors of Successful Pregnancies and Deliveries After Abdominal Radical Trachelectomy for Early-stage Cervical Cancer; Single-institution Experience
    AU  - Motoki Takenaka
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    AB  - We assessed pregnancies and deliveries after abdominal radical trachelectomy (ART) based on reproductive outcomes. We retrospectively analyzed patients undergoing ART in our hospital from 2011 to 2020. Twenty-one patients (median age, 35 [range 27-40] years) with histologically diagnosed cervical cancer (squamous cell carcinoma [n=16], adenocarcinoma [n=4] and adenosquamous carcinoma [n=1]) underwent ART. Clinical stages (FIGO 2018) were IA1 (n=2), IA2 (n=5) and IB1 (n=14). Median follow-up period was 49 (1-108) months with no post-ART recurrence. Among 10 patients with post-ART planned pregnancies, 6 patients had pregnancies. Although all patients in the pregnancy group had pregnancies at the first fertility treatment, none of patients in the non-pregnancy group had pregnancies after several fertility treatment. Age, period after ART and the rate of bilateral uterine arteries preservation showed no significant difference between the pregnancy and non-pregnancy groups. Residual cervical length was about 10 mm in the pre-term delivery group and over 20 mm in the full-term delivery group. Age, fertility treatment and score of normal bacteria flora of the vagina showed no significant difference between pre-term delivery group and full-term delivery group. Bilateral uterine arteries preservation in the ART procedures were not associated with pregnancies after ART. Residual cervical length was associated with gestational age at delivery.
    VL  - 9
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Author Information
  • Department of Obstetrics and Gynecology, Gifu University School of Medicine, Gifu, Japan

  • Department of Obstetrics and Gynecology, Gifu University School of Medicine, Gifu, Japan

  • Department of Obstetrics and Gynecology, Gifu University School of Medicine, Gifu, Japan

  • Department of Obstetrics and Gynecology, Gifu University School of Medicine, Gifu, Japan

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