Obstetrical prognosis of patients who underwent vaginal radical trachelectomy during pregnancy

• Published in: The journal of obstetrics and gynaecology research Vol. 45; no. 6; pp. 1167 - 1172
• Main Authors: Umemoto, Mina, Ishioka, Shinichi, Mizugaki, Yuko, Fujibe, Yuya, Mariya, Tasuku, Kawamata, Akari, Mizuuchi, Masahito, Morishita, Miyuki, Baba, Tsuyoshi, Saito, Tsuyoshi
• Format: Journal Article
• Language: English
• Published: Kyoto, Japan John Wiley & Sons Australia, Ltd 01-06-2019; Wiley Subscription Services, Inc
• Subjects: Abortion, Induced; Adult; Apgar Score; Cervical cancer; Cervix; Female; fertility; Follow-Up Studies; Humans; Infant, Newborn; Invasiveness; Neoplasm Staging; Pregnancy; Pregnancy Complications, Neoplastic - surgery; Pregnancy Outcome; trachelectomy; Trachelectomy - methods; Treatment Outcome; Uterine cancer; Uterine Cervical Neoplasms - surgery; Uterus; Vagina; trachelectomy; cervical cancer; fertility; pregnancy
• ISSN: 1341-8076; 1447-0756
• DOI: 10.1111/jog.13964

Aim
Radical trachelectomy (RT) with pelvic lymphadenectomy has become an option for young patients with early invasive uterine cervical cancer who decide to maintain their fertility. However, this operative method entails a high risk for the following pregnancy due to its radicality. Therefore, RT for pregnant patients can be a challenge both for gynecologic oncologists and obstetricians.
Methods
We have performed vaginal RT for five pregnant patients with uterine cervical cancer stage 1B1 according to the method of Dargent et al. The operations were performed between 16 and 26 weeks of pregnancy, and the patients were followed up carefully according to the follow‐up methods we reported previously.
Results
Vaginal RT was performed for five patients without any troubles. Four of the patients continued their pregnancies until almost 34 weeks or longer under our previously published follow‐up schedule. The pregnancy of one patient was terminated at 26 weeks due to recurrence of the cancer.
Conclusion
Expansion of vaginal RT for pregnant patients with uterine cervical cancer could be a practical option for pregnant patients with early invasive uterine cervical cancer.