Reproductive Outcomes after Laparoscopic Radical Trachelectomy for Early-stage Cervical Cancer

ZHU Ding-jun; ZHANG Wei; LYU Qiong-ying; ZHANG Juan; LI Fei; ZHENG Wen-jing

Abstract：Objective: The objective of this study was to estimate the reproductive outcome of young women with early-stage cervical cancer who underwent fertility-sparing laparoscopic radical trachelectomy (LRT). Methods:We performed a retrospective review of the medical records of patients with early-stage cervical cancer who underwent LRT from April 2006 to December 2013. Clinicopathological data were obtained from patient medical records ,and reproductive outcome data were obtained from patient medical records and telephone interviews. Results:Twenty-two patients who underwent successful LRT were included in this study. The median age of patients was 32 years(range,22 to 40 years),and the median follow-up time after LRT was 28 months (range,3 to 82 months). Menstruation resumed in all patients after LRT,with twenty patients (90.9%) and two patients (9.1%) reporting regular and irregular menstruation,respectively. Five patients(22.7%) presented with cervical stenosis,which was manifested by regular but decreased menstrual flow and newly-developed dysmenorrhea. These patients underwent cervical cannulation and dilatation. Eleven pregnancies (including 3 missed abortions,6 preterm births and 2 full-term births) occurred in 7 patients after LRT. Seven out of 12 patients gave birth to 6 healthy babies. The pregnancy rate after LRT was 58.3%(7/12). The spontaneous abortion rate and live birth rate were 27.3%(3/11) and 72.7%(8/11),respectively. The preterm birth rate was 54.5%(6/11). Conclusions:Pregnancy and live birth rates after LRT were promising; however,the preterm birth rate was relatively high. Cervical stenosis also occurred in a small percentage of patients.