Use of Abdominal Radical Trachelectomy to Treat Cervical Cancer Greater Than 2 cm in Diameter
Use of Abdominal Radical Trachelectomy to Treat Cervical Cancer Greater Than 2 cm in Diameter
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DOI：
10.1097/igc.0b013e318295fb41
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发表时间：
2013-07-01
影响因子：
4.8
通讯作者：
Ungar, Laszlo
中科院分区：
文献类型：
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作者：
Lintner, Balazs;Saso, Srdjan;Ungar, Laszlo
目的：浸润性宫颈癌是最常见的癌症之一，每年有50万新发病例。生育力保存已成为许多癌症幸存者整体生活质量的一个重要组成部分。专家意见建议，保留生育功能的手术应限于那些被诊断为直径小于2厘米的宫颈癌患者。我们的目的是报告我们在另一组患者——即那些直径大于2厘米的宫颈癌患者中进行经腹根治性宫颈切除术（ART）的经验。
方法：1999年至2006年期间，在作者所在的3个机构（匈牙利布达佩斯、英国伦敦、美国纽约），共有45例国际妇产科联合会（FIGO）分期为IB1 - IB2且直径大于2厘米的宫颈癌患者接受了保留生育功能的ART和盆腔淋巴结清扫术。对她们进行了5年以上的随访。
结果：对于69%的患者（n = 31），完成的ART被认为是治愈性的，不建议进行辅助治疗。在这些患者中，93.5%（n = 29）在随访时仍然存活。31%的患者（n = 14）立即完成了根治性子宫切除术。8名希望怀孕的患者中有3名产下了健康的新生儿。
结论：本病例系列的5年生存率（93.5%）与文献中报道的接受根治性子宫切除术患者的生存率相等（或更高）。我们的生存数据似乎支持这样的假设：对于直径大于2厘米的浸润性宫颈癌病灶患者，ART是一种安全的治疗选择。
Objective: Invasive cervical cancer is one of the most common cancers, with 500,000 new cases diagnosed annually. Fertility preservation has become an important component of the overall quality of life of many cancer survivors. Expert opinion has suggested that fertility-sparing surgery should be limited to those patients diagnosed with cervical cancer less than 2 cm in diameter. Our objective was to report our abdominal radical trachelectomy (ART) experience in the opposite group of patients-those with a cervical cancer more than 2 cm in diameter.Methods: Between 1999 and 2006, a total of 45 patients with cervical carcinoma at International Federation of Gynecology and Obstetrics stage IB1-IB2 measuring more than 2 cm in diameter underwent fertility-sparing ART and pelvic lymphadenectomy at the 3 institutions where the authors are based (Budapest, Hungary; London, United Kingdom; New York, United States). They were followed up for more than 5 years.Results: For 69% of patients (n = 31), completed ART was considered to have been curative, and no adjuvant treatment was advised. Of those patients, 93.5% (n = 29) were alive at the time of follow-up. Thirty-one percent of patients (n = 14) underwent immediate completion of radical hysterectomy. Three of 8 patients who wished to fall pregnant delivered healthy neonates.Conclusions: The 5-year survival rate (93.5%) for this case series is equal (or better) to rates reported in the literature for patient treated with radical hysterectomy. Our survival data seem to support the hypothesis that ART is a safe treatment option for patients with invasive cervical cancer lesions of more than 2 cm.