The Survival Rate and Surgical Morbidity of Abdominal Radical Trachelectomy Versus Abdominal Radical Hysterectomy for Stage IB1 Cervical Cancer.

Abstract

To compare the survival rates and morbidities of abdominal radical trachelectomy (ART) to abdominal radical hysterectomy (ARH) for stage IB1 cervical cancer and to evaluate the safety of ART for tumors measuring 2-4cm. We performed a retrospective study to compare the outcomes of patients with stage IB1 cervical cancer who underwent ART to patients treated with ARH who met the inclusion criteria of a fertility-sparing surgery. All of the patients were treated by the same surgeon at our institution in the same period. Of the 107 and 141 patients who underwent ART and ARH, respectively, 61 and 82 patients had a tumor ≥2cm (P=NS). With a median follow-up of 30 and 49months, 2 patients treated with ART and 3 patients treated with ARH recurred: the 5-year RFS rate was 96.5 and 94.8%, respectively, for tumors ≥2cm (P=NS). Only 3 patients died in the ARH group: the 5-year OS rate was 100% for the ART and 94.8% for the ARH group for tumors ≥2cm (P=NS). Incidence rates of intraoperative complications were similar in the two groups (1.9% for ART and 0.7% for ARH, P=NS). However, incidence rates of postoperative complications were higher in the ART group (36.4% for ART and 19.1% for ARH, P<0.05). ART appears to have equal survival rates to ARH and can be performed safely in stage IB1 cervical cancers ≥2cm. However, ART is associated with more postoperative morbidities compared with ARH.