Clinical effect and influence on fertility outcomes of vaginal radical trachelectomy in young patients with early stage of cervical cancer

Abstract

Objective To explore clinical effect and effect on fertility outcomes of vaginal radical trachelectomy (VRT) in young patients with early stage of cervical cancer. Methods Sixty cases of young patients with early stage of cervical cancer treated with radical trachelectomy in our hospital between June 2005 and May 2014 were retrospectively analyzed and conducted follow-up visits. The patients were divided into two groups based on different operation methods: VRT group (n=32) and abdominal radical trachelectomy (ART) group (n=28). The clinical effects and fertility outcomes of the two groups were compared. Results The blood loss of VRT group was significantly lesser than that of ART group [(278.00±97.00)ml vs. (496.00±135.00)ml, t=7.247, P<0.05]. The length of vaginal hysterectomy and the width of parametrial resection of VRT group were significantly shorter than those of ART group [(2.58±0.33)cm vs. (3.01±0.19)cm, t=6.277, P<0.05; (2.34±0.31)cm vs. (2.88±0.25)cm, t=7.357, P<0.05]. During the follow-up visits, the recurrence rate of VRT group was significantly lower than that of ART group (3.1% vs. 25.0%, χ2=6.18, P<0.05). The recurrence of early cervical cancer was related to age (χ2=21.33, P<0.05), diameter of tumor (χ2=21.43, P<0.05), pathology (χ2=40.69, P<0.05) and operation methods (χ2=6.18, P<0.05). The pregnancy rate and fertility rate of VRT group were significantly higher than those of ART group (37.5% vs. 25.0%, χ2=15.33, P<0.05; 28.1% vs. 17.9%, χ2=10.32, P<0.05). Conclusion VRT for young patients with early cervical cancer is safe and feasible. It's worthy of clinical promotion because it can reduce operation damage and recurrence rate, and can efficiently preserve the fertility of patients. Key words: Uterine cervical neoplasms; Fertility; Radical trachelectomy