Surgical, Oncological and Obstetric Outcomes After Radical Abdominal Trachelectomy for Early-Stage Cervical Cancer at a Single Tertiary Center.

Abstract Purpose Radical trachelectomy is a viable option to preserve fertility for young patients with early cervical cancer. The aim of this study was to report surgical, oncological and obstetric outcomes of patients treated with radical abdominal trachelectomy at our institution. Methods A retrospective chart analysis and telephone survey for all patients with early stage cervical cancer treated with a radical abdominal trachelectomy and pelvic lymphadenectomy between 2007 and 2019 at the Department of Obstetrics and Gynaecology at the Medical University of Vienna, Austria was performed. Results Radical abdominal trachelectomy with pelvic lymph-node dissection was attempted for 22 patients. Four cases required conversion to radical hysterectomy due to positive resection margins and two cases required primary chemo-radiotherapy due to positive lymph nodes. Sixteen successfully abdominal radical trachelectomies preserving fertility were performed with two of these patients treated with neo-adjuvant chemotherapy. With a median follow-up time of 21.5 (6.5- 57.25) months, one patient (4.5%) had disease recurrence and subsequently died from cervical cancer. Six patients attempted to conceive, with a resulting four pregnancies with a live birth rate of 75%. Conclusion Abdominal radical trachelectomy is a safe procedure for women with early stage cervical cancer who desire fertility preservation. Surgery should be performed at a high volume gynaeco-oncological center.