Int J Gynecol Cancer. 2018 May;28(4):782-787. doi: 10.1097/IGC.0000000000001218.
Cervical cancer is one of the most frequently diagnosed cancers in pregnancy. Our aim was to evaluate the safety and efficacy of abdominal radical trachelectomy (ART) for pregnant women with early-stage cervical cancer who strongly desire to preserve their pregnancies.
METHODS/MATERIALS: A retrospective observational study was performed for stage IB1 cervical cancer patients who underwent ART or radical hysterectomy (RH) at our hospital between February 2013 and June 2017. We compared differences in perioperative findings and oncologic outcomes among ART during pregnancy (ART-DP), ART, and RH groups.
A total of 38 patients were included in this analysis. Six, 10, and 22 patients were assigned to the ART-DP, ART, and RH groups, respectively. There were no significant differences in the distribution of pathological TNM classifications, histology, tumor size, stromal invasion, and lymph-vascular space invasion among the 3 groups. The patients in the ART-DP group were younger than those in the RH group (P = 0.014). The ART-DP group was associated with more blood loss and prolonged surgery compared with the RH group (P = 0.017 and P = 0.014). The number of total lymph nodes in the ART-DP group was lower than that in the RH group (P = 0.036). However, there were no significant differences in age, surgical time, blood loss, or lymph node count between the ART-DP and ART groups. There were no significant differences in progression-free and overall survival times among the 3 groups, and no recurrence was observed in the ART-DP group.
Abdominal radical trachelectomy may be a tolerable treatment option for pregnant women with early-stage cervical cancer who strongly desire a baby.
宫颈癌是妊娠期最常见的癌症之一。我们的目的是评估对于强烈希望保留妊娠的早期宫颈癌孕妇施行经腹根治性宫颈切除术（ART）的安全性和有效性。
方法/材料：对 2013 年 2 月至 2017 年 6 月期间在我院接受 ART 或根治性子宫切除术（RH）治疗的 IB1 期宫颈癌患者进行回顾性观察性研究。我们比较了妊娠期间 ART（ART-DP）、ART 和 RH 组之间围手术期发现和肿瘤学结果的差异。
共纳入 38 例患者，分别归入 ART-DP 组（6 例）、ART 组（10 例）和 RH 组（22 例）。三组患者的病理 TNM 分期、组织学、肿瘤大小、间质浸润和脉管间隙浸润分布无显著差异。ART-DP 组患者比 RH 组患者年轻（P=0.014）。ART-DP 组与 RH 组相比，出血量更多，手术时间更长（P=0.017 和 P=0.014）。ART-DP 组的总淋巴结数少于 RH 组（P=0.036）。但是，ART-DP 组和 ART 组在年龄、手术时间、出血量或淋巴结计数方面无显著差异。三组患者的无进展生存时间和总生存时间无显著差异，ART-DP 组无复发。
对于强烈希望保留妊娠的早期宫颈癌孕妇，ART 可能是一种可接受的治疗选择。
