Surgical, oncologic, and obstetric outcomes of radical trachelectomy in early-stage cervical cancer: results from a retrospective cohort study at Brazil National Cancer Institute
Objectiveto analyze oncological, obstetrical, and surgical results of young early-stage cervical cancer patients who underwent radical trachelectomy (RT) surgery and wished to maintain their fertility.Methodologya retrospective cohort study was carried out concerning cases attended at the Brazilian...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-03-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1267625/full |
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| author | José Augusto Bellotti José Augusto Bellotti Isabella Gonçalves Gutierres Isabella Gonçalves Gutierres Yara Lúcia Furtado Yara Lúcia Furtado Patricia Patury Juliana de Almeida Figueiredo Gustavo Guitmann Rossano Keppler Alvin Fiorelli Fernanda Campos da Silva |
| author_facet | José Augusto Bellotti José Augusto Bellotti Isabella Gonçalves Gutierres Isabella Gonçalves Gutierres Yara Lúcia Furtado Yara Lúcia Furtado Patricia Patury Juliana de Almeida Figueiredo Gustavo Guitmann Rossano Keppler Alvin Fiorelli Fernanda Campos da Silva |
| author_sort | José Augusto Bellotti |
| collection | DOAJ |
| description | Objectiveto analyze oncological, obstetrical, and surgical results of young early-stage cervical cancer patients who underwent radical trachelectomy (RT) surgery and wished to maintain their fertility.Methodologya retrospective cohort study was carried out concerning cases attended at the Brazilian National Cancer Institute Gynecology Oncology Service. Patients who underwent RT between January 2005 and January 2021 were included.ResultsA total of 32 patients with median age of 32 years old, 62.5% of whom were nulliparous, were assessed. Concerning cancer type, 65.6% squamous cell carcinoma (SCC) cases, 31.2% adenocarcinoma cases and 3.1% adenosquamous carcinoma cases were verified. Stage IA2 was evidenced in 12.5% of the patients and stage IB < 4 cm in 87.5%. Regarding surgical approaches, 68.25% of the patients underwent vaginal RT (VRT), 18.75%, abdominal RT (ART), 9.3%, the robotic radical trachelectomy (RORT) and 3.1%, video laparoscopy radical trachelectomy (VLRT). The median number of removed lymph nodes was 14, with only two detected as positive. Two cases of positive surgical margins were noted. A total of 3.1% intraoperative and 31.25% postoperative complications were observed, with cervical stenosis being the most common. The recurrence rate of the study was 3.1%, with a median follow-up time of 87 months, where 3.1% deaths occurred. The pregnancy rate of the study was 17.85% (5/28), with 54.5% evolving to live births and 45.5% evolving to abortion.ConclusionRadical trachelectomy is a feasible procedure presenting good oncological results and acceptable pregnancy rates. |
| first_indexed | 2024-04-25T01:32:05Z |
| format | Article |
| id | doaj.art-3c8911c551c8474b83fc1764bd06a460 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-25T01:32:05Z |
| publishDate | 2024-03-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-3c8911c551c8474b83fc1764bd06a4602024-03-08T11:10:15ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-03-011410.3389/fonc.2024.12676251267625Surgical, oncologic, and obstetric outcomes of radical trachelectomy in early-stage cervical cancer: results from a retrospective cohort study at Brazil National Cancer InstituteJosé Augusto Bellotti0José Augusto Bellotti1Isabella Gonçalves Gutierres2Isabella Gonçalves Gutierres3Yara Lúcia Furtado4Yara Lúcia Furtado5Patricia Patury6Juliana de Almeida Figueiredo7Gustavo Guitmann8Rossano Keppler Alvin Fiorelli9Fernanda Campos da Silva10Department of Gynecologic Oncology, National Cancer Institute, Rio de Janeiro, RJ, BrazilDepartment of Gynecology and Obstetrics, Rio de Janeiro State Federal University, Rio de Janeiro, RJ, BrazilDepartment of Gynecology and Obstetrics, Rio de Janeiro State Federal University, Rio de Janeiro, RJ, BrazilDepartment of Internal Medicine, University of Brasília, Brasília, DF, BrazilDepartment of Gynecology and Obstetrics, Rio de Janeiro State Federal University, Rio de Janeiro, RJ, BrazilDepartment of Gynecology, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, BrazilDepartment of Gynecologic Oncology, National Cancer Institute, Rio de Janeiro, RJ, BrazilDepartment of Gynecologic Oncology, National Cancer Institute, Rio de Janeiro, RJ, BrazilDepartment of Gynecologic Oncology, National Cancer Institute, Rio de Janeiro, RJ, BrazilDepartment of Gynecology and Obstetrics, Rio de Janeiro State Federal University, Rio de Janeiro, RJ, BrazilDepartment of Gynecology and Obstetrics, Rio de Janeiro State Federal University, Rio de Janeiro, RJ, BrazilObjectiveto analyze oncological, obstetrical, and surgical results of young early-stage cervical cancer patients who underwent radical trachelectomy (RT) surgery and wished to maintain their fertility.Methodologya retrospective cohort study was carried out concerning cases attended at the Brazilian National Cancer Institute Gynecology Oncology Service. Patients who underwent RT between January 2005 and January 2021 were included.ResultsA total of 32 patients with median age of 32 years old, 62.5% of whom were nulliparous, were assessed. Concerning cancer type, 65.6% squamous cell carcinoma (SCC) cases, 31.2% adenocarcinoma cases and 3.1% adenosquamous carcinoma cases were verified. Stage IA2 was evidenced in 12.5% of the patients and stage IB < 4 cm in 87.5%. Regarding surgical approaches, 68.25% of the patients underwent vaginal RT (VRT), 18.75%, abdominal RT (ART), 9.3%, the robotic radical trachelectomy (RORT) and 3.1%, video laparoscopy radical trachelectomy (VLRT). The median number of removed lymph nodes was 14, with only two detected as positive. Two cases of positive surgical margins were noted. A total of 3.1% intraoperative and 31.25% postoperative complications were observed, with cervical stenosis being the most common. The recurrence rate of the study was 3.1%, with a median follow-up time of 87 months, where 3.1% deaths occurred. The pregnancy rate of the study was 17.85% (5/28), with 54.5% evolving to live births and 45.5% evolving to abortion.ConclusionRadical trachelectomy is a feasible procedure presenting good oncological results and acceptable pregnancy rates.https://www.frontiersin.org/articles/10.3389/fonc.2024.1267625/fullcervical cancertrachelectomyfertility preservationgynecologic surgical oncologypregnancy |
| spellingShingle | José Augusto Bellotti José Augusto Bellotti Isabella Gonçalves Gutierres Isabella Gonçalves Gutierres Yara Lúcia Furtado Yara Lúcia Furtado Patricia Patury Juliana de Almeida Figueiredo Gustavo Guitmann Rossano Keppler Alvin Fiorelli Fernanda Campos da Silva Surgical, oncologic, and obstetric outcomes of radical trachelectomy in early-stage cervical cancer: results from a retrospective cohort study at Brazil National Cancer Institute Frontiers in Oncology cervical cancer trachelectomy fertility preservation gynecologic surgical oncology pregnancy |
| title | Surgical, oncologic, and obstetric outcomes of radical trachelectomy in early-stage cervical cancer: results from a retrospective cohort study at Brazil National Cancer Institute |
| title_full | Surgical, oncologic, and obstetric outcomes of radical trachelectomy in early-stage cervical cancer: results from a retrospective cohort study at Brazil National Cancer Institute |
| title_fullStr | Surgical, oncologic, and obstetric outcomes of radical trachelectomy in early-stage cervical cancer: results from a retrospective cohort study at Brazil National Cancer Institute |
| title_full_unstemmed | Surgical, oncologic, and obstetric outcomes of radical trachelectomy in early-stage cervical cancer: results from a retrospective cohort study at Brazil National Cancer Institute |
| title_short | Surgical, oncologic, and obstetric outcomes of radical trachelectomy in early-stage cervical cancer: results from a retrospective cohort study at Brazil National Cancer Institute |
| title_sort | surgical oncologic and obstetric outcomes of radical trachelectomy in early stage cervical cancer results from a retrospective cohort study at brazil national cancer institute |
| topic | cervical cancer trachelectomy fertility preservation gynecologic surgical oncology pregnancy |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1267625/full |
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