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Evaluation of adjuvant chemotherapy after abdominal trachelectomy for cervical cancer: a single-institution experience

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Abstract

Background

To avoid the loss of fertility, chemotherapy should be chosen as an adjuvant treatment after trachelectomy. Our study evaluated the effectiveness and safety of adjuvant chemotherapy after abdominal trachelectomy for cervical cancer.

Methods

Our institutional review board approved this clinical study, and informed consent was obtained from each patient. We began performing abdominal trachelectomy at our institution in 2005. Deep stromal invasion (more than two-thirds) with lymphovascular space invasion, diffuse cervical invasion, skip lesions in the vagina, and lymphovascular space invasion in the cardinal ligament and vagina were defined as intermediate-risk factors, and parametrial invasion and pelvic lymph node metastasis were defined as high-risk factors. Patients who had intermediate- or high-risk factors received post-trachelectomy adjuvant treatment. The medical records and information of the patients were reviewed retrospectively.

Results

Through January 2020, we performed 212 trachelectomies. Among the included patients, 16 and 7 patients with intermediate- and high-risk cancer, respectively, received adjuvant chemotherapy after trachelectomy (2 and 21 patients underwent abdominal modified radical trachelectomy and radical trachelectomy, respectively). Among these patients, only one (4.3%) experienced relapse and subsequent death of the disease after a median postoperative follow-up of 80 months (range 12–146 months). The 5-year survival rate was 95.5%. Chemotherapy-related life-threatening acute adverse events were not observed. Persistent ovarian dysfunction and late adverse events did not occur. One woman achieved three pregnancies, and two infants were delivered.

Conclusion

Adjuvant chemotherapy after abdominal trachelectomy could be an alternative treatment option from the aspects of effectiveness, safety, and fertility preservation.

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Acknowledgements

The authors thank Masako Kijima, Nobuko Yasutake, Hironori Kenjo, and Emiko Hori for their technical assistance. We also thank Joe Barber Jr., Ph.D., and H. Nikki March, Ph.D., from Edanz Group (https://en-author-services.edanzgroup.com/ac), for editing a draft of this manuscript.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Kaoru Okugawa, Hideaki Yahata, Keisuke Kodama, Hiroshi Yagi, Tatsuhiro Ohgami, Masafumi Yasunaga, Ichiro Onoyama, Eisuke Kaneki, Kazuo Asanoma & Kiyoko Kato

  2. Gynecology Service, NHO National Kyushu Cancer Center, 3-1-1 Notame, Minami-Ku, Fukuoka, 811-1395, Japan

    Kenzo Sonoda

  3. Department of Obstetrics and Gynecology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan

    Hiroaki Kobayashi

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  1. Kaoru Okugawa
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  2. Hideaki Yahata
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  4. Keisuke Kodama
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Correspondence to Kaoru Okugawa.

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Okugawa, K., Yahata, H., Sonoda, K. et al. Evaluation of adjuvant chemotherapy after abdominal trachelectomy for cervical cancer: a single-institution experience. Int J Clin Oncol 26, 216–224 (2021). https://doi.org/10.1007/s10147-020-01778-8

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  • DOI: https://doi.org/10.1007/s10147-020-01778-8

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