A fertility-sparing alternative to radical hysterectomy: how many patients may be eligible?

Objective. To determine the percentage of patients with early-stage cervical cancer who may be eligible for fertility preservation with laparoscopic radical vaginal trachelectomy (LRVT). Methods. We retrospectively reviewed the records of patients who underwent a radical hysterectomy for invasive cervical cancer at our institution from 12/85 to 8/01, before our use of LRVT at Memorial Sloan-Kettering Cancer Center. Institutional eligibility criteria for LRVT were applied. Patients greater than or equal to40 years of age were considered ineligible. Results. We identified 435 patients who had undergone radical hysterectomy for cervical cancer; 186 were age <40 at surgery and constituted our study population. Eighty-nine (48%) patients may have been eligible by our pathologic criteria. In 12 patients, LRVT may have been aborted or altered because of unexpected disease spread. Conclusion. A significant number of patients <40 with early-stage cervical cancer may be pathologically eligible for LRVT and should be counseled on this preoperatively. (C) 2004 Elsevier Inc. All rights reserved.