Our Summary

This research paper discusses Radical Vaginal Trachelectomy (RVT), a procedure that helps to preserve fertility in women who are in the early stage (stage 1b) of cervical cancer. This method has been around the longest, and therefore, there is a lot of data on it as compared to other similar procedures. However, there are no controlled, randomized studies comparing RVT with other procedures like radical hysterectomy, or comparing RVT done vaginally with other methods such as open surgery, standard laparoscopy, or robotic approaches. The paper aims to discuss the selection process for patients, the procedure itself, and the outcomes of RVT. It also touches on topics related to cervical cancer, cervical cerclage (a procedure to treat cervical weakness), complications, premature labor, and trachelectomy (removal of the cervical part of a woman’s uterus).

FAQs

  1. What is Radical Vaginal Trachelectomy (RVT)?
  2. How does the survival rate compare between RVT and radical hysterectomy for stage 1b cervical cancer?
  3. Are there any complications associated with the RVT procedure?

Doctor’s Tip

A doctor may advise a patient undergoing a radical hysterectomy to follow their post-operative care instructions closely, including avoiding heavy lifting and strenuous activity for a certain period of time to promote proper healing. They may also recommend attending follow-up appointments as scheduled to monitor recovery and address any concerns promptly. Additionally, the doctor may recommend discussing with the patient the potential impact of the surgery on fertility and options for fertility preservation if desired.

Suitable For

Patients with early stage cervical cancer (Stage 1A2 to 1B1) who desire fertility preservation are typically recommended radical hysterectomy. This includes patients who are young and have a desire for future childbearing. Additionally, patients with certain types of cervical cancer, such as adenocarcinoma or small cell carcinoma, may also be candidates for radical hysterectomy. The decision to undergo a radical hysterectomy should be made in consultation with a gynecologic oncologist, who can assess the individual patient’s specific situation and determine the most appropriate treatment plan.

Timeline

Before radical hysterectomy:

  • Patient is diagnosed with stage 1b cervical cancer
  • Patient undergoes pre-operative evaluations such as imaging tests and blood work
  • Patient discusses options with healthcare provider and decides on radical hysterectomy
  • Patient undergoes counseling on potential risks and benefits of the surgery
  • Patient may undergo cervical cerclage to preserve fertility

After radical hysterectomy:

  • Patient undergoes surgery to remove the cervix, uterus, and surrounding tissues
  • Patient may experience pain and discomfort post-surgery
  • Patient may need to stay in the hospital for a few days for monitoring
  • Patient will have follow-up appointments to monitor recovery and discuss any potential complications
  • Patient may experience changes in sexual function and fertility as a result of the surgery
  • Patient will undergo regular screenings and follow-ups to monitor for recurrence of cancer.

What to Ask Your Doctor

  1. What are the risks and benefits of a radical hysterectomy compared to other treatment options for my stage 1b cervical cancer?
  2. How will a radical hysterectomy impact my fertility and future ability to have children?
  3. What is the success rate of a radical hysterectomy in terms of removing all cancer cells and preventing recurrence?
  4. What is the recovery process like after a radical hysterectomy and what can I expect in terms of pain and complications?
  5. Are there any alternative, less invasive treatments available for my stage 1b cervical cancer?
  6. How many radical hysterectomies have you performed and what is your success rate with this procedure?
  7. What is the long-term outlook for patients who undergo a radical hysterectomy for stage 1b cervical cancer?
  8. Are there any lifestyle changes or precautions I should take after undergoing a radical hysterectomy?
  9. Will I need any additional treatments, such as radiation or chemotherapy, after the radical hysterectomy?
  10. What are the chances of experiencing complications, such as premature labor, after a radical hysterectomy?

Reference

Authors: Ind T. Journal: Best Pract Res Clin Obstet Gynaecol. 2021 Sep;75:65-71. doi: 10.1016/j.bpobgyn.2021.04.005. Epub 2021 May 6. PMID: 34099413