Objective To update the oncological results and identify recurrent risk factors in young patients with early stage cervical cancers following abdominal radical trachelectomy (ART). Design Retrospective study. Setting A university-based cancer hospital. Population Three hundred and thirty-three patients. Methods We conducted a retrospective analysis from a prospectively maintained database of patients undergoing ART from April 2004 to December 2017. Main outcome measures Survival rate, clinicopathological factors related to recurrences. Results Two hundred and seventy-one patients had squamous carcinomas (SCC), 51 had pure adenocarcinomas (AC), and 11 had adenosquamous carcinomas (AS). One hundred thirty-two women (39.6%) had tumours >= 2 cm. With a median follow up of 56 months (range, 6-169), 11 patients (3.3%) had recurrence, and five patients (1.5%) died. The cumulative 5-year recurrence-free survival and overall survival rates were 96.3 and 98.6%, respectively. The recurrence rate in women with tumours >= 2 cm was comparable to that in patients with tumours <2 cm (5.3 versus 2.0%, respectively, P = NS). However, the recurrence rate was significantly higher in patients with AS histology than those with AC and SCC histology (18.2, 3.9, and 2.6%, respectively, P < 0.05). All of the recurrent patients with AS histology had tumours >= 2 cm. Multivariate analysis showed that the only independent risk factor for recurrence was histology type. Conclusions This updated series showed a favourable survival rate following ART. These results further supported that ART was a safe option for well-selected patients with stage IB1 cervical cancers >= 2 cm. However, if patients with tumours >= 2 cm have AS histology, they should be advised with great caution when contemplating ART. Tweetable abstract Abdominal radical trachelectomy could be a safe, fertility-sparing option for strictly selected patients with stage IA1-IB1 cervical cancers <= 4 cm.
[1]Fudan Univ, Dept Gynaecol Oncol, Shanghai Canc Ctr, Shanghai 200032, Peoples R China;
[2]Fudan Univ, Shanghai Med Coll, Dept Oncol, Shanghai, Peoples R China;
[3]Fudan Univ, Dept Radiol, Shanghai Canc Ctr, Shanghai, Peoples R China
(8.0+极速模式)