Our Summary

Cervical cancer is the second most deadly cancer for women of reproductive age in the United States. For women with early-stage cervical cancer who want to have children, a procedure called abdominal radical trachelectomy (ART) has been suggested. This study examined the short and long-term outcomes of ART compared to another procedure, radical hysterectomy (RH). The researchers looked at five different studies, which included 840 women who had either ART or RH. They found that although ART took longer to perform, it did not affect the five-year survival rate or disease-free survival rate when compared to RH. The study concludes that ART is a safe option for women with early-stage cervical cancer who want to preserve their fertility.

FAQs

  1. What is abdominal radical trachelectomy (ART) and why is it suggested for women with early-stage cervical cancer?
  2. Is there a difference in survival rates between patients who undergo ART and those who undergo radical hysterectomy (RH)?
  3. Is abdominal radical trachelectomy (ART) a safe option for women with early-stage cervical cancer who wish to preserve their fertility?

Doctor’s Tip

One helpful tip a doctor might tell a patient about radical hysterectomy is to discuss all possible treatment options, including abdominal radical trachelectomy, with a gynecologic oncologist to determine the best course of action for their individual situation. It is important for patients to weigh the potential benefits and risks of each procedure in order to make an informed decision about their treatment plan. Additionally, patients should discuss any concerns or questions they have with their healthcare provider to ensure they fully understand the procedure and its potential impact on their health and fertility.

Suitable For

Patients who are typically recommended for radical hysterectomy include those with early-stage cervical cancer, particularly those who do not wish to preserve their fertility. Other patients who may be recommended for radical hysterectomy include those with advanced cervical cancer, uterine cancer, or other gynecologic cancers that have spread to the cervix. Additionally, patients with certain precancerous conditions of the cervix, such as severe dysplasia or carcinoma in situ, may also be recommended for radical hysterectomy. Ultimately, the decision to undergo a radical hysterectomy should be made in consultation with a gynecologic oncologist and based on the individual patient’s specific situation and medical history.

Timeline

Before radical hysterectomy:

  1. Diagnosis of early-stage cervical cancer through Pap smear or biopsy.
  2. Consultation with gynecologic oncologist to discuss treatment options, including radical hysterectomy.
  3. Pre-operative testing and preparation for surgery, which may include imaging studies and blood work.
  4. Consent process for surgery, including discussion of potential risks and benefits.
  5. Surgery to remove the uterus, cervix, and surrounding tissues, typically done through an abdominal incision.
  6. Recovery period in the hospital, which may last several days.
  7. Follow-up appointments with the surgeon to monitor healing and discuss further treatment options, if needed.

After radical hysterectomy:

  1. Recovery period at home, which may involve pain management and restrictions on physical activity.
  2. Follow-up appointments with the surgeon to monitor healing and address any concerns.
  3. Possible referral to a medical oncologist for further treatment, such as chemotherapy or radiation therapy.
  4. Long-term monitoring for recurrence of cancer, including regular Pap smears and imaging studies.
  5. Counseling and support for coping with the physical and emotional effects of surgery, such as loss of fertility.
  6. Ongoing discussions with healthcare providers about overall health and well-being, including lifestyle changes to reduce the risk of cancer recurrence.

What to Ask Your Doctor

  1. What is a radical hysterectomy and how is it different from other types of hysterectomy procedures?
  2. What are the potential risks and complications associated with a radical hysterectomy?
  3. How will a radical hysterectomy affect my fertility and ability to have children in the future?
  4. What is the success rate of preserving fertility with a radical trachelectomy compared to a radical hysterectomy?
  5. How long is the recovery time after a radical hysterectomy and what can I expect during the recovery process?
  6. Will I need any additional treatments or follow-up care after a radical hysterectomy?
  7. Are there any alternative treatment options to consider besides a radical hysterectomy?
  8. How will a radical hysterectomy impact my sexual function and overall quality of life?
  9. What is the long-term prognosis for women who undergo a radical hysterectomy for early-stage cervical cancer?
  10. Are there any support resources or counseling services available for women considering a radical hysterectomy?

Reference

Authors: Prodromidou A, Iavazzo C, Fotiou A, Psomiadou V, Douligeris A, Vorgias G, Kalinoglou N. Journal: Arch Gynecol Obstet. 2019 Jul;300(1):25-31. doi: 10.1007/s00404-019-05176-y. Epub 2019 May 6. PMID: 31062151