639 results match your criteria radical trachelectomy


Curative effect of laparoscopic-assisted vaginal radical trachelectomy combined with pelvic lymph node dissection on early-stage cervical cancer.

J BUON 2021 May-Jun;26(3):684-690

Obstetrics and Gynaecology, West China Second University Hospital of Sichuan University, Chengdu, China.

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. Read More

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UK-trained specialists perform first radical trachelectomy in Trinidad and Tobago.

Int J Gynecol Cancer 2021 Jul 14. Epub 2021 Jul 14.

Pathology, San Fernando General Hospital (SWRHA), San Fernando, Trinidad and Tobago.

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Conservative (non-radical) surgery for stage IB1 cervical cancer.

Best Pract Res Clin Obstet Gynaecol 2021 May 24. Epub 2021 May 24.

Consultant Gynaecological Oncologist, Queen Elizabeth Hospital, Gateshead, NE9 6SX, UK. Electronic address:

There has been lively debate in recent years following the publication of various retrospective case series and small cohort studies that suggest certain women presenting with International Federation of Gynecology and Obstetrics (FIGO) stage IB1 cervical cancer (pre-2018 revised classification) may be treated by non-radical surgery, either simple hysterectomy or cone biopsy, where fertility preservation is required. A strictly defined histological criterion is necessary for selecting such cases, incorporating tumour dimensions including estimated tumour volume, lympho-vascular space invasion and pelvic lymph node status. Meta-analyses of these studies show that the oncological outcomes are comparable to the excellent results achieved by radical hysterectomy and radical trachelectomy. Read More

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Neoadjuvant chemotherapy followed by fertility sparing surgery in cervical cancers size 2-4 cm; emerging data and future perspectives.

Gynecol Oncol 2021 Jun 12. Epub 2021 Jun 12.

AdventHealth Cancer Institute Gynecologic Oncology Program, College of Medicine, Orlando, FL 32804, USA; Florida State University, College of Medicine, Orlando, FL 32804, USA. Electronic address:

Background: Approach to the management of early stage cervical cancers with tumor size >2 cm in women who desire fertility preservation has been fraught with controversy. Fertility sparing surgery for FIGO 2018 stage IB cancers has been validated most for tumors ≤2 cm. In this review, our objective was to evaluate the oncologic and obstetric outcomes for women that underwent neoadjuvant chemotherapy (NACT) before fertility sparing surgery for tumors 2-4 cm. Read More

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Radical vaginal trachelectomy.

Authors:
Thomas Ind

Best Pract Res Clin Obstet Gynaecol 2021 May 6. Epub 2021 May 6.

Royal Marsden Hospital, London, SW3 6JA, UK; St George's University of London, Cranmer Terrace, Tooting, London SW17 0RE, UK. Electronic address:

Radical vaginal trachelectomy (RVT) is the oldest fertility-sparing procedure for stage 1b cervical cancer. For that reason, there are more published data for RVT than for all the other radical trachelectomy approaches. However, there are no randomised controlled studies between RVT and radical hysterectomy proving the comparability of survival and no randomised controlled studies comparing a vaginal approach with open, standard laparoscopy and robotic approaches. Read More

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Transabdominal cerclage in early pregnancy for cervical shortening after radical trachelectomy: A case report.

Case Rep Womens Health 2021 Jul 20;31:e00323. Epub 2021 May 20.

Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara Nishihara, Okinawa 903-0215, Japan.

Radical trachelectomy (RT) is a method of fertility preservation for patients with early invasive uterine cervical cancer stage IA2 or IB1 with a tumor diameter of ≤2 cm. However, women who have undergone RT have high risks of abortion and premature birth. To prevent premature birth, cervical cerclage is performed in patients with an ultra-short cervix, but the portio vaginalis is not visible in these patients, and transvaginal uterine cervical cerclage is almost impossible. Read More

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Successful pregnancy following transmyometrial embryo transfer after robot-assisted radical trachelectomy.

Clin Exp Reprod Med 2021 Jun 25;48(2):184-187. Epub 2021 May 25.

Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.

Radical trachelectomy is a fertility-preserving alternative to radical hysterectomy in carefully selected young women with early-stage cervical cancer. However, in cases with subsequent severe cervical stenosis, assisted reproductive techniques can be difficult. This is a case report of a 34-year-old patient who underwent robot-assisted radical trachelectomy and cerclage for early-stage (IB2) adenosquamous carcinoma. Read More

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Overview of fertility sparing treatments for cervical cancer.

Authors:
Thomas Ind

Best Pract Res Clin Obstet Gynaecol 2021 May 6. Epub 2021 May 6.

Royal Marsden Hospital, London, SW3 6JA, UK; St George's University of London, Cranmer Terrace, Tooting, London SW17 0RE, UK. Electronic address:

Until the late 1980s, the mainstay of treatment for cervical cancer has been either hysterectomy or radiotherapy. From the mid to late 1990s, surgical treatments have been focussed more on sparing fertility by preserving the corpus of the womb with trachelectomy or even conserving part of the cervical stroma with a cone biopsy. In carefully selected cases, less radical treatment that preserves the uterus has been considered safe. Read More

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Villoglandular adenocarcinoma of the uterine cervix: a systematic review and meta-analysis.

Arch Gynecol Obstet 2021 Aug 25;304(2):317-327. Epub 2021 May 25.

Center for Pathology Allgaeu, Klinikverbund Allgaeu, Kempten, Germany.

Purpose: Villoglandular adenocarcinoma (VGA) of the uterine cervix has been classified as a rare subtype of cervical adenocarcinoma with good prognosis. A conservative surgical approach is considered feasible. The main risk factor is the presence of other histologic types of cancer. Read More

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Abdominal radical trachelectomy as fertility-sparing management for early stages of cervical cancer: Our experience in 18 cases.

Exp Ther Med 2021 Jul 23;22(1):674. Epub 2021 Apr 23.

First Obstetrics and Gynecology Clinic, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540136 Târgu Mures, Romania.

The aim of this study was to present our experience of 18 cases of abdominal radical trachelectomy (ART), including 5 performed during pregnancy, analyzing patient selection, surgical complications, and oncological and obstetrical outcomes. This reproductive study included all early stage cervical cancer patients referred for ART at the 1st Obstetrics and Gynecology Clinic of the Emergency Clinical County Hospital Targu Mures, between 2010 and 2020. A total of 19 women were considered for ART, and only 1 case required conversion to radical hysterectomy. Read More

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The Multi-Course Approach of Photodynamic Therapy to Treat Invasive Cervical Cancer IB2: A Case Report.

Case Rep Oncol 2021 Jan-Apr;14(1):506-519. Epub 2021 Mar 22.

Center for Innovative Medical Technologies "European Clinic", Moscow, Russian Federation.

Cervical cancer is an important problem in women's health and a worldwide oncological disease. In 2018, the WHO registered 569,847 new cases in the world, and 3.4% were in the Russian Federation. Read More

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Management of pregnancy after radical trachelectomy.

Gynecol Oncol 2021 Jul 24;162(1):220-225. Epub 2021 Apr 24.

Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.

Radical trachelectomy (RT) is a surgery for early-stage cervical cancer treatment that preserves the childbearing ability, and its use has become increasingly common worldwide. Thus, the rate of conception in women who have undergone RT is increasing. However, pregnancy after RT is associated with a higher risk of several obstetric complications such as preterm delivery, preterm premature membrane rupture, and abnormal bleeding from varices at the site of uterovaginal anastomosis. Read More

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Minimally invasive radical trachelectomy: Considerations on surgical approach.

Best Pract Res Clin Obstet Gynaecol 2021 Feb 20. Epub 2021 Feb 20.

Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Current evidence supports that radical trachelectomy is a safe and feasible alternative to patients with early-stage cervical cancer who wish to preserve fertility. In addition, published retrospective literature supports that oncologic outcomes are equivalent to those of radical hysterectomy. First published as a vaginal approach, a number of other approaches have been reported including laparotomic, laparoscopic, and robotic. Read More

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February 2021

The impact on obstetric outcomes following complete amputation of the cervix uteri in fertility preservation surgery for cervical neoplasm.

Eur J Obstet Gynecol Reprod Biol 2021 May 26;260:171-176. Epub 2021 Mar 26.

Institute of Cancer and Genomic Sciences, University of Birmingham, Vincent Drive, Birmingham, B15 2TT, United Kingdom; Pan-Birmingham Gynaecological Cancer Centre, City Hospital, Dudley Road, Birmingham, B18 7QH, United Kingdom. Electronic address:

Objectives: Radical trachelectomy is offered to women with early-stage cervical neoplasia who desire fertility. The presence of isthmic glands within histological specimens suggests complete cervical amputation and as such, we examined if the presence of these glands in surgical specimens adversely affects obstetric outcomes.

Study Design: The study cohort comprises 43 consecutive cases of early-stage cervical neoplasia. Read More

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Clinical significance of kinesin family member 2A as a facilitating biomarker of disease surveillance and prognostication in cervical cancer patients.

Ir J Med Sci 2021 Apr 2. Epub 2021 Apr 2.

Department of Obstetrics and Gynecology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, 7th Floor, Renji Building, No. 26 Shengli Street, Jiang'an District, Wuhan, 430000, China.

Background: Cervical cancer is one of the most common and fatal malignancies among females, and biomarkers are essential for assisting in its management. Kinesin family member 2A (KIF2A) has been exhibited to be a potential maker in various cancers; however, its role in cervical cancer has yet to be reported. Therefore, we aimed to assess the expression of KIF2A and its correlation with clinicopathological characteristics as well as survival profile in cervical cancer patients. Read More

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Expectant management for early pregnancy miscarriage after radical trachelectomy: A single hospital-based study.

Acta Obstet Gynecol Scand 2021 Jul 12;100(7):1322-1325. Epub 2021 Apr 12.

Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.

Introduction: Women who have undergone radical trachelectomy as a fertility-sparing treatment for early-stage cervical cancer may be at higher risk for retained tissues after early-term miscarriage due to cervical cerclage or cervical necrosis. Dilatation and curettage or aspiration may present additional risks in these women. The aim of this study was to assess the efficacy of expectant management for early pregnancy miscarriage after radical trachelectomy. Read More

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Sentinel lymph node biopsy and morbidity outcomes in early cervical cancer: Results of a multicentre randomised trial (SENTICOL-2).

Eur J Cancer 2021 May 24;148:307-315. Epub 2021 Mar 24.

Anne-Sophie Bats, Hôpital Européen Georges Pompidou, Service de Gynécologie, 20-40 Rue Leblanc, 75908 Paris Cedex 15, France.

Introduction: Pelvic lymph node dissection has been the standard of care for patients with early cervical cancer. Sentinel node (SN) mapping is safe and feasible and may increase the detection of metastatic disease, but benefits of omitting pelvic lymph node dissection in terms of decreased morbidity have not been demonstrated.

Materials And Methods: In an open-label study, patients with early cervical carcinoma (FIGO 2009 stage IA2 to IIA1) were randomly assigned to SN resection alone (SN arm) or SN and pelvic lymph node dissection (SN + PLND arm). Read More

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Radical trachelectomy.

Int J Gynecol Cancer 2021 Jul 11;31(7):1068-1074. Epub 2021 Mar 11.

Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.

Radical trachelectomy is the 'cornerstone' of fertility-sparing surgery in patients with early-stage cervical cancer wishing to preserve fertility. Growing evidence has demonstrated the oncologic safety and subsequent favorable pregnancy outcomes in well-selected cases. In the absence of prospective trials, the decision on the appropriate surgical approach (vaginal, open, or minimally invasive surgery) should be based on local resources and surgeons' preferences. Read More

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Prospective assessment of urinary and bowel symptoms, and sexual function between laparoscopic assisted vaginal radical trachelectomy and radical hysterectomy.

Int J Gynecol Cancer 2021 Mar;31(3):484-489

Department of Gynecology, Asklepios Clinic Lich, Hessen, Germany.

Objective: Radical trachelectomy is a valid alternative to radical hysterectomy in women with a desire to retain their fertility. Data regarding the oncological outcomes of radical trachelectomy are comparable with those of radical hysterectomy but information regarding urinary and sexual function is limited. The aim of this study was to prospectively evaluate and compare quality of life, urinary and bowel symptoms, and sexual dysfunction between patients who underwent laparoscopic assisted vaginal radical trachelectomy versus radical hysterectomy for early-stage cervical cancer. Read More

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Uterine transposition for gynecological cancers.

Int J Gynecol Cancer 2021 Mar;31(3):442-446

Department of Surgical Oncology, Erasto Gaertner Hospital, Curitiba, Brazil

Objective: Uterine transposition has emerged as an alternative for fertility preservation in women with pelvic malignancies that require radiotherapy. The goal of this study was to evaluate the short-term outcomes of patients undergoing uterine transposition after trachelectomy for cervical cancer or before chemoradiation for vaginal cancer.

Methods: We retrospectively evaluated patients with early stage cervical cancer after radical trachelectomy or with vaginal cancer with indication for pelvic radiation who had uterine transposition performed as fertility sparing strategy. Read More

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Neoadjuvant chemotherapy prior to fertility-sparing surgery in cervical tumors larger than 2 cm: a systematic review on fertility and oncologic outcomes.

Int J Gynecol Cancer 2021 Mar;31(3):387-398

Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Bogota, Colombia

Background: Management of cervical cancer tumors >2 cm has been a subject of controversy, with management often considered as either up-front radical trachelectomy or neoadjuvant chemotherapy before fertility-sparing surgery.

Methods: A systematic literature review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) checklist. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO). Read More

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Endocervical Adenocarcinoma, Gross Examination, and Processing, Including Intraoperative Evaluation: Recommendations From the International Society of Gynecological Pathologists.

Int J Gynecol Pathol 2021 Mar;40(Suppl 1):S24-S47

The International Society of Gynecological Pathologists (ISGyP) Endocervical Adenocarcinoma Project aims to provide evidence-based guidance for the pathologic evaluation, classification, and reporting of endocervical adenocarcinoma. This review presents the recommendations pertaining to gross evaluation and intraoperative consultation of specimens obtained from patients in the setting of cervical cancer. The recommendations are the product of review of published peer-reviewed evidence, international guidelines and institutional grossing manuals, as well as deliberation within this working group. Read More

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Vaginal delivery after robot-assisted uterine artery-preserving radical trachelectomy for early-stage cervical cancer.

Obstet Gynecol Sci 2021 May 4;64(3):317-321. Epub 2021 Feb 4.

Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.

Radical trachelectomy is conducted in women with early stage cervical cancer who strongly desire fertility preservation. To improve fertility outcomes, the preservation of the uterine artery has been suggested, which can be feasible by minimally invasive surgery using laparoscopy or robots. Although cesarean delivery is required for maternal and fetal health, vaginal delivery is a concern due to the fast delivery process of risk of preterm labor. Read More

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Factors affecting parametrial involvement in cervical cancer patients with tumor size ≤4 cm and selection of low-risk patient group

J Turk Ger Gynecol Assoc 2021 02 28;22(1):37-41. Epub 2021 Jan 28.

Department of Obstetrics and Gynecology, Başkent University Faculty of Medicine, Ankara, Turkey

Objective: The primary aim of this study was to evaluate the factors affecting parametrial involvement in cervical cancer patients with tumor size ≤4 cm and selection of the low-risk patient group based on long-term oncologic outcomes.

Material And Methods: Cervical cancer patients operated in the gynecologic oncology division between 2007 and 2013 were retrospectively evaluated. One-hundred and sixty-eight patients with tumor size ≤4 cm were identified. Read More

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February 2021

The Double Life-Saving Approach of Abdominal Radical Trachelectomy during Pregnancy for Early-Stage Cervical Cancer-An Overview of the Literature and Our Institutional Experience.

J Pers Med 2021 Jan 5;11(1). Epub 2021 Jan 5.

First Obstetrics and Gynecology Clinic, University of Medicine, Pharmacy, Science and Technology "G.E. Palade" of Târgu Mureș, Gheorghe Marinescu Street, Number 38, 540142 Târgu Mureș, Romania.

(1) Background: Cervical cancer is the most common type of cancer encountered during pregnancy, with a frequency of 0.8-1.5 cases per 10,000 births. Read More

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January 2021

Reduced response to controlled ovarian stimulation after radical trachelectomy: A pitfall of fertility-sparing surgery for cervical cancer.

Int J Gynaecol Obstet 2021 Jul 13;154(1):162-168. Epub 2021 Jan 13.

Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Objective: To clarify the decrease in response to controlled ovarian stimulation in patients who receive in vitro fertilization treatment after radical trachelectomy.

Methods: The outcomes of ovarian stimulation were retrospectively evaluated and compared between patients who have undergone radical trachelectomy and control patients who had male factor infertility or unexplained infertility.

Results: A total of 30 ovarian stimulation cycles in 14 radical trachelectomy patients and 54 cycles in 30 control patients were reviewed. Read More

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Pelvic nerves during radical trachelectomy.

Authors:
Lei Li Ming Wu

Int J Gynecol Cancer 2021 01;31(1):154

Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China.

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January 2021

Fertility-sparing Surgery for Patients with Cervical, Endometrial, and Ovarian Cancers.

J Minim Invasive Gynecol 2021 03 26;28(3):392-402. Epub 2020 Dec 26.

Division of Reproductive Endocrinology and Infertility (Dr. Christianson), Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Objective: Nearly 10% of the 1.3 million women living with a gynecologic cancer are aged <50 years. For these women, although their cancer treatment can be lifesaving, it's also life-altering because traditional surgical procedures can cause infertility and, in many cases, induce surgical menopause. Read More

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Minimally invasive versus open radical trachelectomy for early-stage cervical cancer: protocol for a multicenter randomized controlled trial in China.

Trials 2020 Dec 14;21(1):1022. Epub 2020 Dec 14.

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Shuaifuyuan No. 1, Dongcheng District, Beijing, 100730, China.

Background: There are limited data comparing the oncologic and fertility outcomes of patients with early-stage cervical cancer (CC) treated by minimally invasive radical trachelectomy (MIRT) or abdominal radical trachelectomy (ART). The purpose of this multicenter study is to compare the oncologic and fertility outcomes of patients treated by MIRT or ART in a randomized controlled manner in China.

Methods: This is a noninferiority, randomized controlled trial performed at 28 Chinese centers; the study is designed to compare the oncologic and fertility outcomes of patients treated by MIRT (robot-assisted or laparoscopic RT) or ART. Read More

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December 2020

Robotic radical trachelectomy with an abdominally placed vaginal cerclage for containment of early stage cervical cancer.

Gynecol Oncol Rep 2020 Nov 10;34:100673. Epub 2020 Nov 10.

Department of Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA.

•Uterine manipulator elimination may minimize cervical tumor fractionation.•Tumor containment with a vaginal purse-string suture may minimize tumor dissemination.•Further studies of the efficacy of such MIS surgical modifications are warranted. Read More

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November 2020