Abdominal radical trachelectomy during pregnancy: A systematic review of the literature.
Cervical cancer
Fertility sparing
Pregnancy
Radical trachelectomy
Journal
Journal of gynecology obstetrics and human reproduction
ISSN: 2468-7847
Titre abrégé: J Gynecol Obstet Hum Reprod
Pays: France
ID NLM: 101701588
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
17
03
2019
revised:
25
06
2019
accepted:
01
07
2019
pubmed:
6
7
2019
medline:
8
1
2021
entrez:
6
7
2019
Statut:
ppublish
Résumé
Lack of large trials or randomized studies characterize any type of treatment for cervical cancer during pregnancy experimental. To accumulate the existing evidence on abdominal radical trachelectomy (ART) during pregnancy. Medline, Scopus and Google Scholar databases were thoroughly searched up to September 2018 for relevant studies in this field using the terms "Radical Trachelectomy", "Pregnancy", "Cervical cancer", "fertility sparring". Observational studies and case reports which addressed cases of pregnant women who underwent ART for cervical cancer during pregnancy were included. A total of ten studies which recruited 19 patients were finally included. At the time of ART, the gestational age of patients ranged from 7th to 22th weeks. Mean operative time of ART was 351.8 min while mean blood loss was 1,040.35 ml and 5 patients (50%) received blood transfusion. Fetal loss rate was 21.1% (n = 4) and from the completed deliveries 7 (46,66%) were preterm. Postoperative maternal related complication rate was 23.1% (n = 3/13). The mean follow-up was 16.89 months (SD 12.69), whereas all cases were free of disease without evidence of recurrence during their follow-up. According to the existing evidence, ART may be a tolerable option for pregnant women with early-stage cervical cancer with acceptable oncological and obstetrical outcomes. Future multicenter randomized trials are of particular importance to elucidate the optimal treatment option.
Sections du résumé
BACKGROUND
BACKGROUND
Lack of large trials or randomized studies characterize any type of treatment for cervical cancer during pregnancy experimental.
OBJECTIVE
OBJECTIVE
To accumulate the existing evidence on abdominal radical trachelectomy (ART) during pregnancy.
SEARCH STRATEGY
METHODS
Medline, Scopus and Google Scholar databases were thoroughly searched up to September 2018 for relevant studies in this field using the terms "Radical Trachelectomy", "Pregnancy", "Cervical cancer", "fertility sparring".
SELECTION CRITERIA
METHODS
Observational studies and case reports which addressed cases of pregnant women who underwent ART for cervical cancer during pregnancy were included.
MAIN RESULTS
RESULTS
A total of ten studies which recruited 19 patients were finally included. At the time of ART, the gestational age of patients ranged from 7th to 22th weeks. Mean operative time of ART was 351.8 min while mean blood loss was 1,040.35 ml and 5 patients (50%) received blood transfusion. Fetal loss rate was 21.1% (n = 4) and from the completed deliveries 7 (46,66%) were preterm. Postoperative maternal related complication rate was 23.1% (n = 3/13). The mean follow-up was 16.89 months (SD 12.69), whereas all cases were free of disease without evidence of recurrence during their follow-up.
CONCLUSIONS
CONCLUSIONS
According to the existing evidence, ART may be a tolerable option for pregnant women with early-stage cervical cancer with acceptable oncological and obstetrical outcomes. Future multicenter randomized trials are of particular importance to elucidate the optimal treatment option.
Identifiants
pubmed: 31276846
pii: S2468-7847(19)30169-2
doi: 10.1016/j.jogoh.2019.07.003
pii:
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
101607Informations de copyright
Copyright © 2019 Elsevier Masson SAS. All rights reserved.