Oncological and Obstetric Results After Radical Trachelectomy as the Fertility-Sparing Therapy on Early-Stage (FIGO 2018 Stage IA2-IB3) Cervical Cancer Patients

Purpose: To explore the oncological and obstetric results after radical trachelectomy in early-stage cervical cancer. Methods: Retrospective analysis of the oncological and obstetric results to 23 patients with early cervical cancer (stage IA2-IB3; International Federation of Gynecology and Obstetrics 2018) accepting radical trachelectomy in The Maternal and Child Health Care Hospital of Guiyang from Oct 2004 to Sep 2018. Results: Among those patients with tumor size＞4cm (up to 5cm) three patients who wished to preserve fertility accepted radical trachelectomy after neoadjuvant chemotherapy. 23 patients had cervical tumors of the histological type squamous cell carcinoma (SCC). All of the patients retained reproductive function. The mean time of the follow-up was 112.87±55.75months(36-199months). The median tumor size was 2.00±1.35cm (invisible by eyes-5.00cm). No occurred recurrence in any of the cases. Pregnancy outcomes are described as follows: 17 cases attempted to pregnancy, in which 8 cases (47.06%) conceived 12 times. First-trimester abortion and voluntary abandonment of pregnancy occurred in 4 cases (33.33%) respectively, one among patients who choose to abandon pregnancy being induced at 24 weeks of gestation. Second-trimester abortion occurred in3 cases (25.0%), and the reason for abortion was chorioamnionitis. Premature delivery at 32 weeks occurred once (8.33%). Conclusion: Radical trachelectomy is a safe and effective treatment for young women with early-stage cervical cancer. Neoadjuvant chemotherapy and Radical trachelectomy provides the possibility of preserving pregnant ability for patients with cervical tumor＞4cm. However, it is worth further exploration.