Skip to main content
Key Specialties
Anesthesiology Cardiology Dermatology Diabetology Endocrinology Gastroenterology General Medicine Geriatrics Hematology Infectious Diseases Internal Medicine Nephrology Neurology Obstetrics and Gynecology Oncology Pediatrics Psychiatry Radiology Respiratory Medicine Rheumatology Surgery Urology
Congress Coverage
2024 ESMO Congress 2024 ERS Congress 2024 EASD Congress 2024 ESC Congress 2024 EAN Congress 2024 ASCO Annual Meeting 2024 ACC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote series | Spotlight on menopause

Menopause can have a significant impact on the body, with effects ranging beyond the endocrine and reproductive systems. Learn about the systemic effects of menopause, so you can help patients in your clinics through the transition.

Launching: Thursday 12th December 2024
ADVANCED SEARCH
Log in
Top
Journal of Medical Case Reports
Published in:

Open Access 01-12-2024 | Case report

Modified abdominal radical trachelectomy used to spare fertility during surgery for early-stage cervical cancer: a case report

Authors: Thanh Nhan Vo, Long Nguyen, Phuc Nhon Nguyen

Published in: Journal of Medical Case Reports | Issue 1/2024

Login to get access

Abstract

Background

Cervical cancer is the fourth most common malignant tumor in childbearing-age women. To date, cervical resection and fertility-sparing surgery are the trends in the era of minimally invasive management. However, a proper management remains crucial. Hereby, we endeavor to underscore an uncommon case of early-stage cervical cancer receiving a tailored surgical technique of abdominal radical trachelectomy at our tertiary referral center and review literature.

Case presentation

A 33-year-old Vietnamese female patient (E1) was hospitalized for a diagnosis of cervical cancer classified as IB1 stage. The patient was treated with fertility-sparing modified abdominal radical trachelectomy surgery. The postoperative outcome was completely favorable. The patient was sent home after 5 days of hospitalization. In addition, she was monitored without complications.

Conclusion

Fertility-preserving treatment could be effectively performed with a modified technique of abdominal radical trachelectomy among young women with early-stage cervical cancer. Interdisciplinary management is potentially necessary for favorable outcome. Further data are required for long-term outcomes of pregnancy, recurrent rate, and the risk of pelvic organ prolapse.
Literature
1.
Yang M, Du J, Lu H, Xiang F, Mei H, Xiao H. Global trends and age-specific incidence and mortality of cervical cancer from 1990 to 2019: an international comparative study based on the Global Burden of Disease. BMJ Open. 2022;12(7): e055470.CrossRefPubMedPubMedCentral
2.
Singh D, Vignat J, Lorenzoni V, Eslahi M, Ginsburg O, Lauby-Secretan B, et al. Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO Global Cervical Cancer Elimination Initiative. Lancet Glob Health. 2023;11(2):e197–206.CrossRefPubMed
3.
Simms KT, Keane A, Nguyen DTN, Caruana M, Hall MT, Lui G, et al. Benefits, harms and cost-effectiveness of cervical screening, triage and treatment strategies for women in the general population. Nat Med. 2023;29(12):3050–8.CrossRefPubMedPubMedCentral
4.
Boutas I, Sofoudis C, Kalampokas E, Anastasopoulos C, Kalampokas T, Salakos N. Fertility preservation in women with early stage cervical cancer. Review of the literature. Eur J Gynaecol Oncol. 2014;35(4):373–7.PubMed
5.
van der Plas RCJ, Bos AME, Jürgenliemk-Schulz IM, Gerestein CG, Zweemer RP. Fertility-sparing surgery and fertility preservation in cervical cancer: The desire for parenthood, reproductive and obstetric outcomes. Gynecol Oncol. 2021;163(3):538–44.CrossRefPubMed
6.
7.
Ekdahl L, Paraghamian S, Madhuri TK, Eoh KJ, Butler-Manuel S, Kim YT, et al. Robotic-assisted radical trachelectomy for early-stage cervical cancer: reproductive outcomes. Gynecol Oncol. 2021;162:S50–1.CrossRef
8.
Salman L, Covens A. Fertility preservation in cervical cancer-treatment strategies and indications. Curr Oncol (Toronto, Ont). 2024;31(1):296–306.CrossRef
9.
Wu CJ, Chang WC, Chen CH, Chen CA, Huang SC, Sheu BC. Radical trachelectomy for early stage cervical cancer: a case series and literature review. Taiwan J Obstet Gynecol. 2017;56(2):143–6.CrossRefPubMed
10.
Smith ES, Moon AS, O’Hanlon R, Leitao MM Jr, Sonoda Y, Abu-Rustum NR, et al. Radical trachelectomy for the treatment of early-stage cervical cancer: a systematic review. Obstet Gynecol. 2020;136(3):533–42.CrossRefPubMedPubMedCentral
11.
Dargent D, Roy M. Une alternative a l’hysterectomie radicale dans le traitement des cancers infiltrants developpe’s sur la face externe du col ute’rin. J Obstet Gynecol. 1994;2:292–5.
12.
Smith JR, Boyle DC, Corless DJ, Ungar L, Lawson AD, Del Priore G, et al. Abdominal radical trachelectomy: a new surgical technique for the conservative management of cervical carcinoma. Br J Obstet Gynaecol. 1997;104(10):1196–200.CrossRefPubMed
13.
Abu-Rustum NR, Su W, Levine DA, Boyd J, Sonoda Y, Laquaglia MP. Pediatric radical abdominal trachelectomy for cervical clear cell carcinoma: a novel surgical approach. Gynecol Oncol. 2005;97(1):296–300.CrossRefPubMed
14.
Theofanakis C, Koulakmanidis AM, Prodromidou A, Haidopoulos D, Rodolakis A, Thomakos N. Fertility-sparing treatment for young patients with early-stage cervical cancer: a dawn of a new era. Front Surg. 2022;9: 867993.CrossRefPubMedPubMedCentral
15.
Ekdahl L, Paraghamian S, Eoh KJ, Thumuluru KM, Butler-Manuel SA, Kim YT, et al. Long term oncologic and reproductive outcomes after robot-assisted radical trachelectomy for early-stage cervical cancer. An international multicenter study. Gynecol Oncol. 2022;164(3):529–34.CrossRefPubMed
16.
17.
Somigliana E, Mangili G, Martinelli F, Noli S, Filippi F, Bergamini A, et al. Fertility preservation in women with cervical cancer. Crit Rev Oncol Hematol. 2020;154: 103092.CrossRefPubMed
18.
Wethington SL, Sonoda Y, Park KJ, Alektiar KM, Tew WP, Chi DS, et al. Expanding the indications for radical trachelectomy: a report on 29 patients with stage IB1 tumors measuring 2 to 4 centimeters. Int J Gynecol Cancer. 2013;23(6):1092–8.CrossRefPubMedPubMedCentral
19.
Schneider A, Erdemoglu E, Chiantera V, Reed N, Morice P, Rodolakis A, et al. Clinical recommendation radical trachelectomy for fertility preservation in patients with early-stage cervical cancer. Int J Gynecol Cancer. 2012;22(4):659–66.CrossRefPubMed
20.
Kuznicki ML, Chambers LM, Morton M, Son J, Horowitz M, Crean-Tate KK, et al. Fertility-sparing surgery for early-stage cervical cancer: a systematic review of the literature. J Minim Invasive Gynecol. 2021;28(3):513-26.e1.CrossRefPubMed
21.
Al-Niaimi AN, Einstein MH, Perry L, Hartenbach EM, Kushner DM. Uterine artery sparing robotic radical trachelectomy (AS-RRT) for early cancer of the cervix. Int J Gynecol Obstet. 2011;112(1):76–80.CrossRef
22.
Han S, Na J, Li Y, Wang J. Surgical procedures and techniques in robot-assisted uterine artery-preserving radical trachelectomy. J Robot Surg. 2024;18(1):222.CrossRefPubMed
23.
Fujii T. Abdominal radical trachelectomy. Surg J (New York, NY). 2021;7(Suppl 2):S97-s102.
24.
Stolnicu S, Park KJ, Kiyokawa T, Oliva E, McCluggage WG, Soslow RA. Tumor Typing of endocervical adenocarcinoma: contemporary review and recommendations from the international society of gynecological pathologists. Int J Gynecol Pathol. 2021;40(Suppl 1):S75-s91.CrossRefPubMedPubMedCentral
25.
Berek JS, Matias-Guiu X, Creutzberg C, Fotopoulou C, Gaffney D, Kehoe S, et al. FIGO staging of endometrial cancer: 2023. Int J Gynecol Obstet. 2023;162(2):383–94.CrossRef
26.
Yuan P, Liu Z, Qi J, Yang X, Hu T, Tan H. Laparoscopic radical hysterectomy with enclosed colpotomy and without the use of uterine manipulator for early-stage cervical cancer. J Minim Invasive Gynecol. 2019;26(6):1193–8.CrossRefPubMed
27.
Ungár L, Pálfalvi L, Hogg R, Siklós P, Boyle DCM, Del Priore G, et al. Abdominal radical trachelectomy: a fertility-preserving option for women with early cervical cancer. BJOG Int J Obstet Gynaecol. 2005;112(3):366–9.CrossRef
28.
Lee N, Mun J, Park SJ, Lee EJ, Lee S, Kim HS. Vaginal delivery after robot-assisted uterine artery-preserving radical trachelectomy for early-stage cervical cancer. Obstet Gynecol Sci. 2021;64(3):317–21.CrossRefPubMedPubMedCentral
29.
Kim CH, Abu-Rustum NR, Chi DS, Gardner GJ, Leitao MM Jr, Carter J, et al. Reproductive outcomes of patients undergoing radical trachelectomy for early-stage cervical cancer. Gynecol Oncol. 2012;125(3):585–8.CrossRefPubMed
30.
Chen T, Li J, Zhu Y, Lu AW, Zhou L, Wang JS, et al. The oncological and obstetric results of radical trachelectomy as a fertility-sparing therapy in early-stage cervical cancer patients. BMC Womens Health. 2022;22(1):424.CrossRefPubMedPubMedCentral
31.
Lv Z, Wang Y-Y, Wang Y-W, He J-J, Lan W-W, Peng J-Y, et al. A meta-analysis of treatment for early-stage cervical cancer: open versus minimally invasive radical trachelectomy. BMC Pregnancy Childbirth. 2023;23(1):727.CrossRefPubMedPubMedCentral
32.
Willows K, Lennox G, Covens A. Fertility-sparing management in cervical cancer: balancing oncologic outcomes with reproductive success. Gynecol Oncol Res Pract. 2016;3(1):9.CrossRefPubMedPubMedCentral
Metadata
Title
Modified abdominal radical trachelectomy used to spare fertility during surgery for early-stage cervical cancer: a case report
Authors
Thanh Nhan Vo
Long Nguyen
Phuc Nhon Nguyen
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2024
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-024-04937-x

Other articles of this Issue 1/2024

Hemothorax caused by injury of musculophrenic artery after ultrasound-guided percutaneous liver biopsy: a case report

Epstein–Barr virus-positive mucocutaneous ulcer resulting in severe methotrexate intoxication: a case report

Ileal prolapse through patent omphalomesenteric duct in a two year-old boy: a case report

A diagnostically challenging case of pneumocystis pneumonia

Methotrexate-induced leukoencephalopathy presenting as acute-onset limb weakness in a child: a case report

Long-term outcome of adult traumatic atlantoaxial rotatory fixation: a case series

  • Open Access
  • Case Study