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Statements

Subject Item
n2:RIV%2F00064165%3A_____%2F12%3A12393%21RIV13-MZ0-00064165
rdf:type
n10:Vysledek skos:Concept
rdfs:seeAlso
http://dx.doi.org/10.1097/IGC.0b013e318263eee2
dcterms:description
Objectives: Abdominal radical trachelectomy (ART) is a type C resection (uterine vessels ligated at origin from the hypogastric vessels). Questions arise as to whether fertility is maintained after ART, particularly when uterine vessels are sacrificed. We report an international series on ART to describe fertility and oncologic outcomes. Methods: Databases at 3 institutions were queried to identify patients planned for ART from 1999 to 2011. Clinical and demographic data were gathered. Results: One hundred one patients underwent ART. Mean age was 31 years (range, 19-43 years). Histologic classifications were adenocarcinoma (n = 54), squamous cell carcinoma (n = 40), adenosquamous carcinoma (n = 6), and clear cell carcinoma (n = 1). Twenty patients (20%) required conversion to hysterectomy (10 margins and 10 nodes). Eight patients underwent completion hysterectomy owing to the following: positive margins on final pathology (n = 3), patient's choice (n = 4), or recurrence (n = 1). Postoperatively, 20 patients (20%) received adjuvant chemotherapy and/or radiation (4 final pathology margins and 16 nodes). Four patients (4%) had recurrence and lived 22 to 35 months after diagnosis. Of the 70 women who had neither hysterectomy nor adjuvant therapy, 38 (54%) attempted pregnancy and 28 (74%) achieved pregnancy. Thirty-one pregnancies resulted in 16 (52%) third trimester deliveries. Six patients are currently pregnant with outcomes pending. Conclusions: These data demonstrate that ART preserves fertility and maintains excellent oncologic outcomes. Most women (74%) attempting pregnancy after ART are able to achieve pregnancy and deliver in the third trimester (52%). Preservation of the uterine vasculature is not necessary for fertility; obstetrical outcomes are similar to those of the historical vaginal radical trachelectomy cohorts. Objectives: Abdominal radical trachelectomy (ART) is a type C resection (uterine vessels ligated at origin from the hypogastric vessels). Questions arise as to whether fertility is maintained after ART, particularly when uterine vessels are sacrificed. We report an international series on ART to describe fertility and oncologic outcomes. Methods: Databases at 3 institutions were queried to identify patients planned for ART from 1999 to 2011. Clinical and demographic data were gathered. Results: One hundred one patients underwent ART. Mean age was 31 years (range, 19-43 years). Histologic classifications were adenocarcinoma (n = 54), squamous cell carcinoma (n = 40), adenosquamous carcinoma (n = 6), and clear cell carcinoma (n = 1). Twenty patients (20%) required conversion to hysterectomy (10 margins and 10 nodes). Eight patients underwent completion hysterectomy owing to the following: positive margins on final pathology (n = 3), patient's choice (n = 4), or recurrence (n = 1). Postoperatively, 20 patients (20%) received adjuvant chemotherapy and/or radiation (4 final pathology margins and 16 nodes). Four patients (4%) had recurrence and lived 22 to 35 months after diagnosis. Of the 70 women who had neither hysterectomy nor adjuvant therapy, 38 (54%) attempted pregnancy and 28 (74%) achieved pregnancy. Thirty-one pregnancies resulted in 16 (52%) third trimester deliveries. Six patients are currently pregnant with outcomes pending. Conclusions: These data demonstrate that ART preserves fertility and maintains excellent oncologic outcomes. Most women (74%) attempting pregnancy after ART are able to achieve pregnancy and deliver in the third trimester (52%). Preservation of the uterine vasculature is not necessary for fertility; obstetrical outcomes are similar to those of the historical vaginal radical trachelectomy cohorts.
dcterms:title
An International Series on Abdominal Radical Trachelectomy 101 Patients and 28 Pregnancies An International Series on Abdominal Radical Trachelectomy 101 Patients and 28 Pregnancies
skos:prefLabel
An International Series on Abdominal Radical Trachelectomy 101 Patients and 28 Pregnancies An International Series on Abdominal Radical Trachelectomy 101 Patients and 28 Pregnancies
skos:notation
RIV/00064165:_____/12:12393!RIV13-MZ0-00064165
n10:predkladatel
n16:ico%3A00064165
n3:aktivita
n11:N
n3:aktivity
N
n3:cisloPeriodika
7
n3:dodaniDat
n6:2013
n3:domaciTvurceVysledku
n17:3630501
n3:druhVysledku
n13:J
n3:duvernostUdaju
n9:S
n3:entitaPredkladatele
n8:predkladatel
n3:idSjednocenehoVysledku
121996
n3:idVysledku
RIV/00064165:_____/12:12393
n3:jazykVysledku
n12:eng
n3:klicovaSlova
Trachelectomy; Cervical cancer; Fertility preservation; stage cervical-cancer; pathological outcomes; hysterectomy; carcinoma; lymphadenectomy
n3:klicoveSlovo
n4:hysterectomy n4:Fertility%20preservation n4:stage%20cervical-cancer n4:lymphadenectomy n4:Trachelectomy n4:carcinoma n4:Cervical%20cancer n4:pathological%20outcomes
n3:kodStatuVydavatele
US - Spojené státy americké
n3:kontrolniKodProRIV
[871A4C1BAF32]
n3:nazevZdroje
International Journal of Gynecological Cancer
n3:obor
n15:FK
n3:pocetDomacichTvurcuVysledku
1
n3:pocetTvurcuVysledku
8
n3:rokUplatneniVysledku
n6:2012
n3:svazekPeriodika
22
n3:tvurceVysledku
Abu-Rustum, NR Garrett, L. Duska, L. R. Wethington, SL Chi, DS Kim, C. H. Cibula, David Sonoda, Y.
n3:wos
000308216600026
s:issn
1048-891X
s:numberOfPages
7