Robotic Radical Trachelectomy for Early Stage Cervical Cancer: Oncological and Obstetrical Outcomes

Sanson C1,2*, Lecuru F3,4,5, Cancès-Lauwers V6, Martinez A1,7, Classe JM8, Belghiti J9, Collinet P10, Zaccarini F2, Lambaudie F11,12 and Motton S1

1University Institute Cancer Toulouse Oncopole, France
2Institute Gustave Roussy, France
3Hôpital Georges Pompidou, France
4Curie Institute, Paris, France
5University of Medicine Paris Descartes, France
6USMR, CHU Toulouse, France
7Inserm CRCT, Toulouse, France
8Institut de Cancérologie de l’Ouest, France
9University Hospitals Pitié Salpêtrière - Charles Foix, AP-HP, France
10Jeanne de Flandre Hospital, France
11Institut Paoli-Calmettes, France
12Aix-Marseille University, France

^*Correspondance to: Claire Sanson 

 PDF  Full Text DOI: 10.25107/2474-1647.3417

Abstract

Objectives: The aim of this study is to assess the reproductive and oncologic outcome following Robotic Radical Trachelectomy (RRT) in patients with early-stage cervical cancer interested in future fertility. Material and Methods: A retrospective review was performed of patients from three institutions who underwent radical trachelectomy for early-stage cervical cancer from May 2012 to January 2019. Perioperative, oncologic, and fertility outcomes were retrieved from SERGS (Society of European Robotic Gynaecological Surgery) database and an additional review of patient files was performed. Results: Twenty-six patients were included (one IA1 FIGO stage, three IA2, sixteen IB1, six IB2, and one IB3). The median age was 34.4 years, and median follow-up was 34.7 months. The average surgical time was 271 minutes ± 69. No laparoconversion occurred; we reported a ureteral injury, and 30.7% post-operative dysuria (n=8). Four trachelectomies were aborted in favor of a radical hysterectomy and/or chemoradiation due to nodal metastases (n=1), or insufficient margins (n=3). One nodal recurrence occurred in these women (35.9 months after chemotherapy for insufficient margins); and one distant recurrence was observed. Twenty-one patients remained fertile after treatment; among them, three patients conceived naturally. Two patients delivered after 37 weeks, the third patient had two miscarriages. Conclusion: RRT is feasible with acceptable recurrence rate; to better evaluate fertility rate, larger sample and longer follow-up are needed.

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Cite the article

Sanson C, Lecuru F, Cancès-Lauwers V, Martinez A, Classe JM, Belghiti J, et al. Robotic Radical Trachelectomy for Early Stage Cervical Cancer: Oncological and Obstetrical Outcomes. Clin Surg. 2022; 7: 3417.