A Review of Fertility Preservation with Radical Vaginal Trachelectomy and Laparoscopic Pelvic Lymphadenectomy in the Treatment of Early Cervical Cancer

Radical vaginal trachelectomy (RVT) is a relatively new procedure in Gynecologic Oncology. It is gaining acceptance worldwide as a safe management option that allows fertility preservation in women with early cervical carcinoma who are unlikely to require adjuvant therapy. This review of 319 cases reported in the literature includes patient/tumour demographics, operative details, recurrence and fertility rates, and obstetrical outcomes. Reports to date indicate that the recurrence rates are similar to that after radical hysterectomy, yet with the advantages of deceased blood loss and a shorter hospital stay. Importantly, experienced surgeons have been able to offer RVT to young women and thus provide them a reasonable likelihood of achieving pregnancy and obtaining a healthy newborn. Patients should be counseled regarding potential obstetrical complications and the importance of close follow-up for possible recurrence. A randomized study is unlikely ever to be feasible, and therefore, as more data is published, a more accurate analysis of recurrence and pregnancy outcomes will become available.