Ying Wang1, Ao Wang, Jun Zhan, Tao Guo. 1. Obstetrics and Gynaecology, West China Second University Hospital of Sichuan University, Chengdu, China.
Abstract
PURPOSE: The purpose of this study was to explore the safety and feasibility of laparoscopic-assisted vaginal radical trachelectomy (VRT) combined with pelvic lymph node dissection in the treatment of early-stage cervical cancer. METHODS: Patients (N=136) with early-stage cervical cancer were divided into VRT group (laparoscopic-assisted VRT combined with pelvic lymph node dissection, n=68) and abdominal radical trachelectomy (ART) group (ART combined with pelvic lymph node dissection, n=68). The operation-related indexes, incidence of postoperative complications and fertility status were compared between the two groups, and the tumor recurrence status was recorded through follow-up. The factors related to recurrence of early-stage cervical cancer were analyzed by one-way analysis of variance and Cox multivariate regression analysis. RESULTS: VRT group had significantly less intraoperative blood loss and significantly shorter postoperative ventilation time than ART group. In VRT group, the length of vaginal resection and the width of parauterine tissue resection were significantly smaller than those in ART group. The pregnancy rate in VRT group (38.6%) was far higher than that in ART group (21.2%) (p=0.041), while the fertility rate had no statistically significant difference between the two groups (90.9% vs. 81.8%) (p=0.641). The results of univariate and multivariate analysis showed that the tumor diameter was an independent risk factor for the recurrence of early-stage cervical cancer (β=0.317, p=0.029, 95% CI=0.484-0.815). CONCLUSION: VRT is safe and feasible in the treatment of early-stage cervical cancer, which can reduce surgical damage, facilitate postoperative recovery, and effectively preserve the fertility of patients. The tumor diameter is an independent risk factor for the recurrence of early-stage cervical cancer.
PURPOSE: The purpose of this study was to explore the safety and feasibility of laparoscopic-assisted vaginal radical trachelectomy (VRT) combined with pelvic lymph node dissection in the treatment of early-stage cervical cancer. METHODS: Patients (N=136) with early-stage cervical cancer were divided into VRT group (laparoscopic-assisted VRT combined with pelvic lymph node dissection, n=68) and abdominal radical trachelectomy (ART) group (ART combined with pelvic lymph node dissection, n=68). The operation-related indexes, incidence of postoperative complications and fertility status were compared between the two groups, and the tumor recurrence status was recorded through follow-up. The factors related to recurrence of early-stage cervical cancer were analyzed by one-way analysis of variance and Cox multivariate regression analysis. RESULTS: VRT group had significantly less intraoperative blood loss and significantly shorter postoperative ventilation time than ART group. In VRT group, the length of vaginal resection and the width of parauterine tissue resection were significantly smaller than those in ART group. The pregnancy rate in VRT group (38.6%) was far higher than that in ART group (21.2%) (p=0.041), while the fertility rate had no statistically significant difference between the two groups (90.9% vs. 81.8%) (p=0.641). The results of univariate and multivariate analysis showed that the tumor diameter was an independent risk factor for the recurrence of early-stage cervical cancer (β=0.317, p=0.029, 95% CI=0.484-0.815). CONCLUSION: VRT is safe and feasible in the treatment of early-stage cervical cancer, which can reduce surgical damage, facilitate postoperative recovery, and effectively preserve the fertility of patients. The tumor diameter is an independent risk factor for the recurrence of early-stage cervical cancer.