Abstract
Cervical cancer is the third most common female cancer worldwide and the use of routine screening resulted in earlier stage and younger age at diagnosis. Fertility preservation via radical trachelectomy comes up as an option in such patients. Recent literature reviews confirm the safety of this operation with excellent oncologic outcomes in appropriately chosen patients. However, recurrent disease is likely and a strict follow-up is recommended to detect recurrences at an early stage following radical trachelectomy. In this report, a case who underwent radical trachelectomy and developed widespread recurrences 7 years after initial surgery possibly due to the lack of oncologic follow-up is discussed.
Highlights
Cervical cancer is the third most common female cancer worldwide with more than half a million new cases diagnosed and 274,000 deaths occurred annually [1]
More than 40% of all patients diagnosed with invasive cervical cancer are of childbearing age and a significant proportion of these young women are candidates for fertilitysparing surgery [2, 9]
Daniel Dargent described the first successful fertility-sparing surgery in 1986 which was radical vaginal trachelectomy combined with laparoscopic lymphadenectomy [10]
Summary
Cervical cancer is the third most common female cancer worldwide with more than half a million new cases diagnosed and 274,000 deaths occurred annually [1]. The traditional treatment for early cervical cancer is radical hysterectomy and up to 90–95% 5year survival is expected following such treatment in patients with stage 1A2-1B1 disease [3]. This approach is associated with permanent loss of fertility that may cause significant morbidity in form of depression, anxiety, grief, and sexual dysfunction [4]. It was shown that almost 50% of the patients with cervical cancer who are less than 40 years of age are eligible for radical trachelectomy and this approach has become increasingly accepted over the past 20 years [2, 5]. Fertility-sparing surgery in cervical cancer was discussed as well with special emphasis on eligibility criteria, indications for completion surgery and/or adjuvant radiotherapy, oncological safety, pregnancy outcomes, and postoperative follow-up recommendations
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