■分析肿瘤学,产科,和年轻的早期宫颈癌患者的手术结果,这些患者接受了根治性子宫颈切除术(RT)手术并希望维持其生育能力。
■对在巴西国家癌症研究所妇科肿瘤服务处就诊的病例进行了回顾性队列研究。纳入2005年1月至2021年1月接受RT的患者。
■共有32名患者,中位年龄为32岁,62.5%的人是未产的,被评估。关于癌症类型,65.6%鳞状细胞癌(SCC),腺癌病例占31.2%,腺鳞癌病例占3.1%。在12.5%的患者中证实了IA2期,在87.5%中证实了IB期<4cm。关于手术方法,68.25%的患者行阴道RT(VRT),18.75%,腹部RT(ART),9.3%,机器人根治性膀胱切除术(RORT)和3.1%,电视腹腔镜根治术(VLRT)。切除淋巴结的中位数为14个,只有2个检测为阳性。注意到2例手术切缘阳性。术中并发症占3.1%,术后并发症占31.25%,宫颈狭窄是最常见的。该研究的复发率为3.1%,中位随访时间为87个月,其中3.1%死亡。研究的妊娠率为17.85%(5/28),其中54.5%发展为活产,45.5%发展为堕胎。
■根治性子宫切除术是一种可行的手术,具有良好的肿瘤效果和可接受的妊娠率。
UNASSIGNED: to analyze oncological, obstetrical, and surgical results of young early-stage cervical cancer patients who underwent radical
trachelectomy (RT) surgery and wished to maintain their fertility.
UNASSIGNED: a retrospective cohort study was carried out concerning cases attended at the Brazilian National Cancer Institute Gynecology Oncology Service. Patients who underwent RT between January 2005 and January 2021 were included.
UNASSIGNED: A total of 32 patients with median age of 32 years old, 62.5% of whom were nulliparous, were assessed. Concerning cancer type, 65.6% squamous cell carcinoma (SCC) cases, 31.2% adenocarcinoma cases and 3.1% adenosquamous carcinoma cases were verified. Stage IA2 was evidenced in 12.5% of the patients and stage IB < 4 cm in 87.5%. Regarding surgical approaches, 68.25% of the patients underwent vaginal RT (VRT), 18.75%, abdominal RT (ART), 9.3%, the robotic radical
trachelectomy (RORT) and 3.1%, video laparoscopy radical
trachelectomy (VLRT). The median number of removed lymph nodes was 14, with only two detected as positive. Two cases of positive surgical margins were noted. A total of 3.1% intraoperative and 31.25% postoperative complications were observed, with cervical stenosis being the most common. The recurrence rate of the study was 3.1%, with a median follow-up time of 87 months, where 3.1% deaths occurred. The pregnancy rate of the study was 17.85% (5/28), with 54.5% evolving to live births and 45.5% evolving to abortion.
UNASSIGNED: Radical
trachelectomy is a feasible procedure presenting good oncological results and acceptable pregnancy rates.