Qi Lu1, Yunhe Zhang2, Shuzhen Wang1, Shuli Guo1, Hongyan Guo3, Zhenyu Zhang4, Chongdong Liu1. 1. Department of Obstetrics and Gynecology, Chao-yang Hospital, Capital Medical University, Beijing, People's Republic of China. 2. Department of Obstetrics and Gynecology, China Aerospace Science & Industry Corporation 731 Hospital, Beijing, People's Republic of China. 3. Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, People's Republic of China. 4. Department of Obstetrics and Gynecology, Chao-yang Hospital, Capital Medical University, Beijing, People's Republic of China. Electronic address: zhenyuzhang2000@163.com.
Abstract
OBJECTIVE: To support the feasibility and safety of neoadjuvant intra-arterial chemotherapy followed by total laparoscopic radical trachelectomy in stage IB1 cervical cancer with tumor larger than 2 cm. DESIGN: A retrospective study. SETTING: University-affiliated gynecologic oncology department. PATIENT(S): Patients with stage IB1 cervical cancer with tumor size larger than 2 cm who wish to preserve fertility. INTERVENTION(S): Neoadjuvant intra-arterial chemotherapy followed by laparoscopic radical trachelectomy. MAIN OUTCOMES MEASURE(S): Data regarding neoadjuvant chemotherapy operational time, blood loss, recurrence, and subsequent pregnancies were recorded. Other published reports on neoadjuvant chemotherapy followed by radical trachelectomy were reviewed. RESULT(S): Seven patients had a laparoscopic radical trachelectomy after neoadjuvant intra-arterial chemotherapy for stage IB1 cervical cancer. Median tumor diameter evaluated by colposcopy was 3.3 cm (range, 2.5-4.0 cm), tumor histotype was all squamous. All patients showed complete or partial response to neoadjuvant chemotherapy, and they were all treated with total laparoscopic radical trachelectomy. One patient had no menses after treatment. After a median 66 months (range, 12-90 months) of follow-up time, no recurrence was observed. Only four patients attempted to conceive and two succeeded. CONCLUSION(S): Neoadjuvant intra-arterial chemotherapy followed by total laparoscopic radical trachelectomy may become a useful option for women with cervical cancer with a tumor size larger than 2 cm who wish to preserve fertility. Ovarian protection warrants further investigation.
OBJECTIVE: To support the feasibility and safety of neoadjuvant intra-arterial chemotherapy followed by total laparoscopic radical trachelectomy in stage IB1cervical cancer with tumor larger than 2 cm. DESIGN: A retrospective study. SETTING: University-affiliated gynecologic oncology department. PATIENT(S): Patients with stage IB1cervical cancer with tumor size larger than 2 cm who wish to preserve fertility. INTERVENTION(S): Neoadjuvant intra-arterial chemotherapy followed by laparoscopic radical trachelectomy. MAIN OUTCOMES MEASURE(S): Data regarding neoadjuvant chemotherapy operational time, blood loss, recurrence, and subsequent pregnancies were recorded. Other published reports on neoadjuvant chemotherapy followed by radical trachelectomy were reviewed. RESULT(S): Seven patients had a laparoscopic radical trachelectomy after neoadjuvant intra-arterial chemotherapy for stage IB1cervical cancer. Median tumor diameter evaluated by colposcopy was 3.3 cm (range, 2.5-4.0 cm), tumor histotype was all squamous. All patients showed complete or partial response to neoadjuvant chemotherapy, and they were all treated with total laparoscopic radical trachelectomy. One patient had no menses after treatment. After a median 66 months (range, 12-90 months) of follow-up time, no recurrence was observed. Only four patients attempted to conceive and two succeeded. CONCLUSION(S): Neoadjuvant intra-arterial chemotherapy followed by total laparoscopic radical trachelectomy may become a useful option for women with cervical cancer with a tumor size larger than 2 cm who wish to preserve fertility. Ovarian protection warrants further investigation.
Authors: Carlo Ronsini; Maria Cristina Solazzo; Nicolò Bizzarri; Domenico Ambrosio; Marco La Verde; Marco Torella; Raffaela Maria Carotenuto; Luigi Cobellis; Nicola Colacurci; Pasquale De Franciscis Journal: Ann Surg Oncol Date: 2022-09-05 Impact factor: 4.339