Analysis of the security,pregnancy outcomes,and the tumor recurrence related factors of young patients with cervical cancer treated with different radical trachelectomy

Abstract

Objective To explore the security,pregnancy outcomes,and the tumor recurrence related factors of young patients with cervical cancer treated with different radical trachelectomy (RT).Methods Eighty-two young patients (＜ 40 years) with early cervical cancer were divided into two groups based on different operation methods:vaginal radical trachelectomy (VRT) group of 43 cases and abdominal radical trachelectomy (ART) group of 39 cases.The clinical data were analyzed retrospectively,One-way Anova and Multivariate Cox Stepwise Regression analysis were used.Results The number of lymph node dissection,operation duration,postoperative hospitalization time,height of the cervical resection,incidence of postoperative complications,the postoperative pregnancy rate were no statistically significant difference between two groups(P ＞ 0.05).The blood loss,length of vaginal hysterectomy,width of parametrial resection in VRT group were significantly less than those in ART group[(282.7 ± 201.0) ml vs.(429.4 ± 320.8) ml,(2.42 ± 0.51) cm vs.(2.98 ± 0.11) cm,(2.39 ± 0.37) cm vs.(2.82 ± 0.23) cm] (P ＜ 0.05).One-way Anova analysis showed that the recurrence of early cervical cancer was related to tumor diameter size (P ＜ 0.05),while there were no correlation with age,clinical stage,histological type and surgical approach (P ＞ 0.05).Multivariate Cox Stepwise Regression analysis showed that tumor diameter size was an independent risk factor for tumor recurrence(β =0.248,95％ CI 0.077-0.882,P =0.032).Conclusions RT for young patients with early cervical cancer is feasible.Pregnancy outcomes after RT need to be studied in the future.Tumor size in diameter is the major risk factor for tumor recurrence. Key words: Uterine cervical neoplasms; Neoplasm recurrence, local; Gynecologic surgical procedures; Fertility