Reproductive concerns of women treated with radical trachelectomy for cervical cancer.

OBJECTIVE: To report the reproductive concerns of women treated for stage I cervical cancer with fertility-preserving surgery.
MATERIALS AND METHODS: Newly diagnosed cervical cancer patients undergoing radical trachelectomy were enrolled in this study preoperatively and assessed over time. Preliminary data from the preoperative analysis and 3-month and 6-month assessment points addressing reproductive concerns are presented.
RESULTS: Between February 2004 and June 2006, 29 patients were enrolled in the study. Three patients were excluded because they did not undergo the planned surgery and 6 patients were excluded because they required adjuvant therapy. Future childbearing was the main reason most women chose to undergo the procedure; however, treatment choice was also guided by conversations with their doctors (41%, n=12). Twenty-six (90%) initially expressed concern over future conception and childbearing, but this increased to all patients by 6 months. At enrollment, the majority of the patients had high expectations for future conception and childbearing but this declined over time. Despite this, patients' distress gradually decreased over time.
CONCLUSIONS: Our results show that many women who have undergone a radical trachelectomy present with distress and reproductive concerns that persist for up to 6 months postoperatively. Concerns about conception appear to decrease following surgery; however, concerns about pregnancy appear to increase post trachelectomy itself. This pilot study reflects the first preliminary data from an active ongoing study prospectively collecting information over 2 years from newly diagnosed stage I cervical cancer patients undergoing radical trachelectomy.