Evaluation of adjuvant chemotherapy after abdominal trachelectomy for cervical cancer: a single-institution experience
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ORIGINAL ARTICLE
Evaluation of adjuvant chemotherapy after abdominal trachelectomy for cervical cancer: a single‑institution experience Kaoru Okugawa1 · Hideaki Yahata1 · Kenzo Sonoda2 · Keisuke Kodama1 · Hiroshi Yagi1 · Tatsuhiro Ohgami1 · Masafumi Yasunaga1 · Ichiro Onoyama1 · Eisuke Kaneki1 · Kazuo Asanoma1 · Hiroaki Kobayashi3 · Kiyoko Kato1 Received: 22 April 2020 / Accepted: 23 August 2020 © Japan Society of Clinical Oncology 2020
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. Keywords Uterine cervical neoplasms · Trachelectomy · Adjuvant chemotherapy · Treatment outcome
* Kaoru Okugawa [email protected]‑u.ac.jp
Eisuke Kaneki [email protected]‑u.ac.jp
Hideaki Yahata [email protected]‑u.ac.jp
Kazuo Asanoma [email protected]‑u.ac.jp
Kenzo Sonoda [email protected]‑u.ac.jp
Hiroaki Kobayashi [email protected]‑u.ac.jp
Keisuke Kodama [email protected]‑u.ac.jp
Kiyoko Kato [email protected]‑u.ac.jp
Hiroshi Yagi [email protected]‑u.ac.jp
1
Tatsuhiro Ohgami [email protected]‑u.ac.jp
Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, 3‑1‑1 Maidashi, Higashi‑ku, Fukuoka 812‑8582, Japan
2
Masafumi Yasunaga ymasafum
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