Oncological results and recurrent risk factors following abdominal radical trachelectomy: an updated series of 333 patients
Objective To update the oncological results and identify recurrent risk factors in young patients with early stage cervical cancers following abdominal radical trachelectomy (ART). Design Retrospective study. Setting A university‐based cancer hospital. Population Three hundred and thirty‐three patie...
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| Veröffentlicht in: | BJOG : an international journal of obstetrics and gynaecology 2019-08, Vol.126 (9), p.1169-1174 |
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| container_title | BJOG : an international journal of obstetrics and gynaecology |
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| creator | Li, X Li, J Jiang, Z Xia, L Ju, X Chen, X Wu, X |
| description | Objective
To update the oncological results and identify recurrent risk factors in young patients with early stage cervical cancers following abdominal radical trachelectomy (ART).
Design
Retrospective study.
Setting
A university‐based cancer hospital.
Population
Three hundred and thirty‐three patients.
Methods
We conducted a retrospective analysis from a prospectively maintained database of patients undergoing ART from April 2004 to December 2017.
Main outcome measures
Survival rate, clinicopathological factors related to recurrences.
Results
Two hundred and seventy‐one patients had squamous carcinomas (SCC), 51 had pure adenocarcinomas (AC), and 11 had adenosquamous carcinomas (AS). One hundred thirty‐two women (39.6%) had tumours ≥2 cm. With a median follow up of 56 months (range, 6–169), 11 patients (3.3%) had recurrence, and five patients (1.5%) died. The cumulative 5‐year recurrence‐free survival and overall survival rates were 96.3 and 98.6%, respectively. The recurrence rate in women with tumours ≥2 cm was comparable to that in patients with tumours |
| doi_str_mv | 10.1111/1471-0528.15621 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2179388089</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2179388089</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4371-fc78db9704875634a91ad0ac6ca820047f33dcfbfdbc8571ff705b4a61f8acef3</originalsourceid><addsrcrecordid>eNqFkTtPHDEURq0oKDySmi6ylCbNwvV4POOhS1ACQUjbQG3d8QNMPOPFnhFa5c_j3QWKNLjxlXW-I11_hBwzOGHlnLK6ZQsQlTxhoqnYB3Lw9vJxO8MCeCX3yWHODwCsqYB_IvscmoZXIA7Iv-WoY4h3XmOgyeY5TJniaMqs55TsONHk81_qUE8xZepiCPHJj3cUexMHP25iaLbxKaG-t8EWclifFQudVwYna2i2ydtMo6Occ7rCyRdx_kz2HIZsv7zcR-T296-b88vF9fLiz_mP64WueVnG6Vaavmuhlq1oeI0dQwOoG42yAqhbx7nRrnem11K0zLkWRF9jw5xEbR0_It933lWKj7PNkxp81jYEHG2cs6pY23EpQXYF_fYf-hDnVJYsVNWI8sedgEKd7iidYs7JOrVKfsC0VgzUphe1aUFtWlDbXkri64t37gdr3vjXIgogdsCTD3b9nk_9vFruxM-035i9</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2265562950</pqid></control><display><type>article</type><title>Oncological results and recurrent risk factors following abdominal radical trachelectomy: an updated series of 333 patients</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Li, X ; Li, J ; Jiang, Z ; Xia, L ; Ju, X ; Chen, X ; Wu, X</creator><creatorcontrib>Li, X ; Li, J ; Jiang, Z ; Xia, L ; Ju, X ; Chen, X ; Wu, X</creatorcontrib><description>Objective
To update the oncological results and identify recurrent risk factors in young patients with early stage cervical cancers following abdominal radical trachelectomy (ART).
Design
Retrospective study.
Setting
A university‐based cancer hospital.
Population
Three hundred and thirty‐three patients.
Methods
We conducted a retrospective analysis from a prospectively maintained database of patients undergoing ART from April 2004 to December 2017.
Main outcome measures
Survival rate, clinicopathological factors related to recurrences.
Results
Two hundred and seventy‐one patients had squamous carcinomas (SCC), 51 had pure adenocarcinomas (AC), and 11 had adenosquamous carcinomas (AS). One hundred thirty‐two women (39.6%) had tumours ≥2 cm. With a median follow up of 56 months (range, 6–169), 11 patients (3.3%) had recurrence, and five patients (1.5%) died. The cumulative 5‐year recurrence‐free survival and overall survival rates were 96.3 and 98.6%, respectively. The recurrence rate in women with tumours ≥2 cm was comparable to that in patients with tumours <2 cm (5.3 versus 2.0%, respectively, P = NS). However, the recurrence rate was significantly higher in patients with AS histology than those with AC and SCC histology (18.2, 3.9, and 2.6%, respectively, P < 0.05). All of the recurrent patients with AS histology had tumours ≥2 cm. Multivariate analysis showed that the only independent risk factor for recurrence was histology type.
Conclusions
This updated series showed a favourable survival rate following ART. These results further supported that ART was a safe option for well‐selected patients with stage IB1 cervical cancers ≥2 cm. However, if patients with tumours ≥2 cm have AS histology, they should be advised with great caution when contemplating ART.
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Abdominal radical trachelectomy could be a safe, fertility‐sparing option for strictly selected patients with stage IA1–IB1 cervical cancers ≤4 cm.
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Abdominal radical trachelectomy could be a safe, fertility‐sparing option for strictly selected patients with stage IA1–IB1 cervical cancers ≤4 cm.</description><identifier>ISSN: 1470-0328</identifier><identifier>EISSN: 1471-0528</identifier><identifier>DOI: 10.1111/1471-0528.15621</identifier><identifier>PMID: 30663205</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Abdomen ; Abdomen - surgery ; Abdominal radical trachelectomy ; Adenocarcinoma - mortality ; Adenocarcinoma - pathology ; Adenocarcinoma - surgery ; Adenosquamous ; Adult ; Carcinoma ; Carcinoma - mortality ; Carcinoma - pathology ; Carcinoma - surgery ; Carcinoma, Adenosquamous - mortality ; Carcinoma, Adenosquamous - pathology ; Carcinoma, Adenosquamous - surgery ; Carcinoma, Squamous Cell - mortality ; Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - surgery ; Cervical cancer ; Cervix ; Cervix Uteri - pathology ; Cervix Uteri - surgery ; Databases, Factual ; Female ; Fertility Preservation ; fertility‐sparing surgery ; Histology ; Humans ; Multivariate analysis ; Neoplasm Recurrence, Local - etiology ; Neoplasm Recurrence, Local - mortality ; Neoplasm Recurrence, Local - pathology ; Neoplasm Staging ; oncological result ; Prospective Studies ; recurrent risk factor ; Retrospective Studies ; Risk Factors ; Squamous cell carcinoma ; Survival ; Survival Rate ; Trachelectomy - methods ; Trachelectomy - mortality ; Treatment Outcome ; Tumors ; Uterine Cervical Neoplasms - mortality ; Uterine Cervical Neoplasms - pathology ; Uterine Cervical Neoplasms - surgery ; Young Adult</subject><ispartof>BJOG : an international journal of obstetrics and gynaecology, 2019-08, Vol.126 (9), p.1169-1174</ispartof><rights>2019 Royal College of Obstetricians and Gynaecologists</rights><rights>2019 Royal College of Obstetricians and Gynaecologists.</rights><rights>Copyright © 2019 Royal College of Obstetricians and Gynaecologists</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4371-fc78db9704875634a91ad0ac6ca820047f33dcfbfdbc8571ff705b4a61f8acef3</citedby><cites>FETCH-LOGICAL-c4371-fc78db9704875634a91ad0ac6ca820047f33dcfbfdbc8571ff705b4a61f8acef3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2F1471-0528.15621$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2F1471-0528.15621$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30663205$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, X</creatorcontrib><creatorcontrib>Li, J</creatorcontrib><creatorcontrib>Jiang, Z</creatorcontrib><creatorcontrib>Xia, L</creatorcontrib><creatorcontrib>Ju, X</creatorcontrib><creatorcontrib>Chen, X</creatorcontrib><creatorcontrib>Wu, X</creatorcontrib><title>Oncological results and recurrent risk factors following abdominal radical trachelectomy: an updated series of 333 patients</title><title>BJOG : an international journal of obstetrics and gynaecology</title><addtitle>BJOG</addtitle><description>Objective
To update the oncological results and identify recurrent risk factors in young patients with early stage cervical cancers following abdominal radical trachelectomy (ART).
Design
Retrospective study.
Setting
A university‐based cancer hospital.
Population
Three hundred and thirty‐three patients.
Methods
We conducted a retrospective analysis from a prospectively maintained database of patients undergoing ART from April 2004 to December 2017.
Main outcome measures
Survival rate, clinicopathological factors related to recurrences.
Results
Two hundred and seventy‐one patients had squamous carcinomas (SCC), 51 had pure adenocarcinomas (AC), and 11 had adenosquamous carcinomas (AS). One hundred thirty‐two women (39.6%) had tumours ≥2 cm. With a median follow up of 56 months (range, 6–169), 11 patients (3.3%) had recurrence, and five patients (1.5%) died. The cumulative 5‐year recurrence‐free survival and overall survival rates were 96.3 and 98.6%, respectively. The recurrence rate in women with tumours ≥2 cm was comparable to that in patients with tumours <2 cm (5.3 versus 2.0%, respectively, P = NS). However, the recurrence rate was significantly higher in patients with AS histology than those with AC and SCC histology (18.2, 3.9, and 2.6%, respectively, P < 0.05). All of the recurrent patients with AS histology had tumours ≥2 cm. Multivariate analysis showed that the only independent risk factor for recurrence was histology type.
Conclusions
This updated series showed a favourable survival rate following ART. These results further supported that ART was a safe option for well‐selected patients with stage IB1 cervical cancers ≥2 cm. However, if patients with tumours ≥2 cm have AS histology, they should be advised with great caution when contemplating ART.
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Abdominal radical trachelectomy could be a safe, fertility‐sparing option for strictly selected patients with stage IA1–IB1 cervical cancers ≤4 cm.
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Abdominal radical trachelectomy could be a safe, fertility‐sparing option for strictly selected patients with stage IA1–IB1 cervical cancers ≤4 cm.</description><subject>Abdomen</subject><subject>Abdomen - surgery</subject><subject>Abdominal radical trachelectomy</subject><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - surgery</subject><subject>Adenosquamous</subject><subject>Adult</subject><subject>Carcinoma</subject><subject>Carcinoma - mortality</subject><subject>Carcinoma - pathology</subject><subject>Carcinoma - surgery</subject><subject>Carcinoma, Adenosquamous - mortality</subject><subject>Carcinoma, Adenosquamous - pathology</subject><subject>Carcinoma, Adenosquamous - surgery</subject><subject>Carcinoma, Squamous Cell - mortality</subject><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Carcinoma, Squamous Cell - surgery</subject><subject>Cervical cancer</subject><subject>Cervix</subject><subject>Cervix Uteri - pathology</subject><subject>Cervix Uteri - surgery</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>Fertility Preservation</subject><subject>fertility‐sparing surgery</subject><subject>Histology</subject><subject>Humans</subject><subject>Multivariate analysis</subject><subject>Neoplasm Recurrence, Local - etiology</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Staging</subject><subject>oncological result</subject><subject>Prospective Studies</subject><subject>recurrent risk factor</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Squamous cell carcinoma</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>Trachelectomy - methods</subject><subject>Trachelectomy - mortality</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Uterine Cervical Neoplasms - mortality</subject><subject>Uterine Cervical Neoplasms - pathology</subject><subject>Uterine Cervical Neoplasms - surgery</subject><subject>Young Adult</subject><issn>1470-0328</issn><issn>1471-0528</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkTtPHDEURq0oKDySmi6ylCbNwvV4POOhS1ACQUjbQG3d8QNMPOPFnhFa5c_j3QWKNLjxlXW-I11_hBwzOGHlnLK6ZQsQlTxhoqnYB3Lw9vJxO8MCeCX3yWHODwCsqYB_IvscmoZXIA7Iv-WoY4h3XmOgyeY5TJniaMqs55TsONHk81_qUE8xZepiCPHJj3cUexMHP25iaLbxKaG-t8EWclifFQudVwYna2i2ydtMo6Occ7rCyRdx_kz2HIZsv7zcR-T296-b88vF9fLiz_mP64WueVnG6Vaavmuhlq1oeI0dQwOoG42yAqhbx7nRrnem11K0zLkWRF9jw5xEbR0_It933lWKj7PNkxp81jYEHG2cs6pY23EpQXYF_fYf-hDnVJYsVNWI8sedgEKd7iidYs7JOrVKfsC0VgzUphe1aUFtWlDbXkri64t37gdr3vjXIgogdsCTD3b9nk_9vFruxM-035i9</recordid><startdate>201908</startdate><enddate>201908</enddate><creator>Li, X</creator><creator>Li, J</creator><creator>Jiang, Z</creator><creator>Xia, L</creator><creator>Ju, X</creator><creator>Chen, X</creator><creator>Wu, X</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201908</creationdate><title>Oncological results and recurrent risk factors following abdominal radical trachelectomy: an updated series of 333 patients</title><author>Li, X ; Li, J ; Jiang, Z ; Xia, L ; Ju, X ; Chen, X ; Wu, X</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4371-fc78db9704875634a91ad0ac6ca820047f33dcfbfdbc8571ff705b4a61f8acef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Abdomen</topic><topic>Abdomen - surgery</topic><topic>Abdominal radical trachelectomy</topic><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - surgery</topic><topic>Adenosquamous</topic><topic>Adult</topic><topic>Carcinoma</topic><topic>Carcinoma - mortality</topic><topic>Carcinoma - pathology</topic><topic>Carcinoma - surgery</topic><topic>Carcinoma, Adenosquamous - mortality</topic><topic>Carcinoma, Adenosquamous - pathology</topic><topic>Carcinoma, Adenosquamous - surgery</topic><topic>Carcinoma, Squamous Cell - mortality</topic><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Carcinoma, Squamous Cell - surgery</topic><topic>Cervical cancer</topic><topic>Cervix</topic><topic>Cervix Uteri - pathology</topic><topic>Cervix Uteri - surgery</topic><topic>Databases, Factual</topic><topic>Female</topic><topic>Fertility Preservation</topic><topic>fertility‐sparing surgery</topic><topic>Histology</topic><topic>Humans</topic><topic>Multivariate analysis</topic><topic>Neoplasm Recurrence, Local - etiology</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Staging</topic><topic>oncological result</topic><topic>Prospective Studies</topic><topic>recurrent risk factor</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Squamous cell carcinoma</topic><topic>Survival</topic><topic>Survival Rate</topic><topic>Trachelectomy - methods</topic><topic>Trachelectomy - mortality</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Uterine Cervical Neoplasms - mortality</topic><topic>Uterine Cervical Neoplasms - pathology</topic><topic>Uterine Cervical Neoplasms - surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, X</creatorcontrib><creatorcontrib>Li, J</creatorcontrib><creatorcontrib>Jiang, Z</creatorcontrib><creatorcontrib>Xia, L</creatorcontrib><creatorcontrib>Ju, X</creatorcontrib><creatorcontrib>Chen, X</creatorcontrib><creatorcontrib>Wu, X</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, X</au><au>Li, J</au><au>Jiang, Z</au><au>Xia, L</au><au>Ju, X</au><au>Chen, X</au><au>Wu, X</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Oncological results and recurrent risk factors following abdominal radical trachelectomy: an updated series of 333 patients</atitle><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle><addtitle>BJOG</addtitle><date>2019-08</date><risdate>2019</risdate><volume>126</volume><issue>9</issue><spage>1169</spage><epage>1174</epage><pages>1169-1174</pages><issn>1470-0328</issn><eissn>1471-0528</eissn><abstract>Objective
To update the oncological results and identify recurrent risk factors in young patients with early stage cervical cancers following abdominal radical trachelectomy (ART).
Design
Retrospective study.
Setting
A university‐based cancer hospital.
Population
Three hundred and thirty‐three patients.
Methods
We conducted a retrospective analysis from a prospectively maintained database of patients undergoing ART from April 2004 to December 2017.
Main outcome measures
Survival rate, clinicopathological factors related to recurrences.
Results
Two hundred and seventy‐one patients had squamous carcinomas (SCC), 51 had pure adenocarcinomas (AC), and 11 had adenosquamous carcinomas (AS). One hundred thirty‐two women (39.6%) had tumours ≥2 cm. With a median follow up of 56 months (range, 6–169), 11 patients (3.3%) had recurrence, and five patients (1.5%) died. The cumulative 5‐year recurrence‐free survival and overall survival rates were 96.3 and 98.6%, respectively. The recurrence rate in women with tumours ≥2 cm was comparable to that in patients with tumours <2 cm (5.3 versus 2.0%, respectively, P = NS). However, the recurrence rate was significantly higher in patients with AS histology than those with AC and SCC histology (18.2, 3.9, and 2.6%, respectively, P < 0.05). All of the recurrent patients with AS histology had tumours ≥2 cm. Multivariate analysis showed that the only independent risk factor for recurrence was histology type.
Conclusions
This updated series showed a favourable survival rate following ART. These results further supported that ART was a safe option for well‐selected patients with stage IB1 cervical cancers ≥2 cm. However, if patients with tumours ≥2 cm have AS histology, they should be advised with great caution when contemplating ART.
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Abdominal radical trachelectomy could be a safe, fertility‐sparing option for strictly selected patients with stage IA1–IB1 cervical cancers ≤4 cm.
Tweetable
Abdominal radical trachelectomy could be a safe, fertility‐sparing option for strictly selected patients with stage IA1–IB1 cervical cancers ≤4 cm.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>30663205</pmid><doi>10.1111/1471-0528.15621</doi><tpages>6</tpages></addata></record> |
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| issn | 1470-0328 1471-0528 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Abdomen Abdomen - surgery Abdominal radical trachelectomy Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - surgery Adenosquamous Adult Carcinoma Carcinoma - mortality Carcinoma - pathology Carcinoma - surgery Carcinoma, Adenosquamous - mortality Carcinoma, Adenosquamous - pathology Carcinoma, Adenosquamous - surgery Carcinoma, Squamous Cell - mortality Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - surgery Cervical cancer Cervix Cervix Uteri - pathology Cervix Uteri - surgery Databases, Factual Female Fertility Preservation fertility‐sparing surgery Histology Humans Multivariate analysis Neoplasm Recurrence, Local - etiology Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - pathology Neoplasm Staging oncological result Prospective Studies recurrent risk factor Retrospective Studies Risk Factors Squamous cell carcinoma Survival Survival Rate Trachelectomy - methods Trachelectomy - mortality Treatment Outcome Tumors Uterine Cervical Neoplasms - mortality Uterine Cervical Neoplasms - pathology Uterine Cervical Neoplasms - surgery Young Adult |
| title | Oncological results and recurrent risk factors following abdominal radical trachelectomy: an updated series of 333 patients |
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