Important Factors of Successful Pregnancies and Deliveries After Abdominal Radical Trachelectomy for Early-stage Cervical Cancer; Single-institution Experience

Abstract

We assessed pregnancies and deliveries after abdominal radical trachelectomy (ART) based on reproductive outcomes. We retrospectively analyzed patients undergoing ART in our hospital from 2011 to 2020. Twenty-one patients (median age, 35 [range 27-40] years) with histologically diagnosed cervical cancer (squamous cell carcinoma [n=16], adenocarcinoma [n=4] and adenosquamous carcinoma [n=1]) underwent ART. Clinical stages (FIGO 2018) were IA1 (n=2), IA2 (n=5) and IB1 (n=14). Median follow-up period was 49 (1-108) months with no post-ART recurrence. Among 10 patients with post-ART planned pregnancies, 6 patients had pregnancies. Although all patients in the pregnancy group had pregnancies at the first fertility treatment, none of patients in the non-pregnancy group had pregnancies after several fertility treatment. Age, period after ART and the rate of bilateral uterine arteries preservation showed no significant difference between the pregnancy and non-pregnancy groups. Residual cervical length was about 10 mm in the pre-term delivery group and over 20 mm in the full-term delivery group. Age, fertility treatment and score of normal bacteria flora of the vagina showed no significant difference between pre-term delivery group and full-term delivery group. Bilateral uterine arteries preservation in the ART procedures were not associated with pregnancies after ART. Residual cervical length was associated with gestational age at delivery.