Neoadjuvant intraarterial chemotherapy followed by total laparoscopic radical trachelectomy in stage IB1 cervical cancer

Neoadjuvant intra-arterial chemotherapy followed by total LRT may become a useful option for women with cervical cancer with a tumor size larger than 2 cm who wish to preserve fertility.

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Authors

Qi Lu, M.M., Yunhe Zhang, M.M., Shuzhen Wang, M.D., Shuli Guo, M.D., Hongyan Guo, M.D., Zhenyu Zhang, M.D., Chongdong Liu, M.D.

Volume 101, Issue 3, Pages 812-817, March 2014

Abstract

Objective:

To support the feasibility and safety of neoadjuvant intra-arterial chemotherapy followed by total laparoscopic radical trachelectomy in stage IB1 cervical cancer with tumor larger than 2 cm.

Design:

A retrospective study.

Setting:

University-affiliated gynecologic oncology department.

Patient(s):

Patients with stage IB1 cervical cancer with tumor size larger than 2 cm who wish to preserve fertility.

Intervention(s):

Neoadjuvant intra-arterial chemotherapy followed by laparoscopic radical trachelectomy.

Main Outcomes Measure(s):

Data regarding neoadjuvant chemotherapy operational time, blood loss, recurrence, and subsequent pregnancies were recorded. Other published reports on neoadjuvant chemotherapy followed by radical trachelectomy were reviewed.

Result(s):

Seven patients had a laparoscopic radical trachelectomy after neoadjuvant intra-arterial chemotherapy for stage IB1 cervical cancer. Median tumor diameter evaluated by colposcopy was 3.3 cm (range, 2.5–4.0 cm), tumor histotype was all squamous. All patients showed complete or partial response to neoadjuvant chemotherapy, and they were all treated with total laparoscopic radical trachelectomy. One patient had no menses after treatment. After a median 66 months (range, 12–90 months) of follow-up time, no recurrence was observed. Only four patients attempted to conceive and two succeeded.

Conclusion(s):

Neoadjuvant intra-arterial chemotherapy followed by total laparoscopic radical trachelectomy may become a useful option for women with cervical cancer with a tumor size larger than 2 cm who wish to preserve fertility. Ovarian protection warrants further investigation.

Read the full text at: http://www.fertstert.org/article/S0015-0282(13)03389-X/fulltext


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Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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