Long-Term Outcomes After Fertility-Sparing Laparoscopic Radical Trachelectomy in Young Women With Early-Stage Cervical Cancer: An Asan Gynecologic Cancer Group (AGCG) Study

ObjectivesTo evaluate the long-term outcomes and risk factors for recurrence after fertility-sparing laparoscopic radical trachelectomy (LRT) in young women with early-stage cervical cancer. MethodsEighty-eight consecutive patients from four tertiary cancer centers in Korea who had attempted fertility-sparing LRT for early-stage cervical cancer were included in this study. ResultsSeventy-nine patients completed LRT. The mean age and tumor size were 31 years (range, 20-40 years) and 1.8cm (range, 0.4-7cm), respectively. Twenty-nine patients had a tumor size greater than 2cm, 22 had deep stromal invasion greater than 50%, and twelve had lymphovascular space invasion. After a median follow-up time of 44 months (range, 3-105 months), nine patients had recurrence and one had died of disease. A tumor size greater than 2cm (P=0.039) and a depth of stromal invasion greater than 50% (P=0.016) were significant risk factors for recurrence. ConclusionsThis is the largest series on fertility-sparing LRT in young women with early cervical cancer. LRT is a feasible and safe fertility-sparing alternative to radical hysterectomy in these women. A tumor size greater than 2cm and a depth of stromal invasion greater than 50% were risk factors for recurrence. J. Surg. Oncol. 2014 110:252-257. (c) 2014 Wiley Periodicals, Inc.