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Characteristics and outcomes of reproductive-aged women with early-stage cervical cancer: trachelectomy vs hysterectomy.


ABSTRACT: BACKGROUND:Trachelectomy is the treatment of choice for reproductive-aged women with early-stage cervical cancer who desire future fertility. Comprehensive population-based statistics have been missing to date. OBJECTIVE:We sought to compare characteristics and survival of reproductive-aged women who underwent trachelectomy for early-stage cervical cancer to those who had hysterectomy. STUDY DESIGN:This is a retrospective observational study examining the Surveillance, Epidemiology, and End Results program from 1998 through 2014. Women <45 years of age with stage IA and IB1 (tumor size ≤2 cm) cervical cancer who underwent trachelectomy were compared to those who underwent hysterectomy. Multivariable models were used to identify clinicopathological factors associated with trachelectomy. Survival was compared between the 2 groups after propensity score matching. RESULTS:Among 6359 women, 190 (3.0%; 95% confidence interval, 2.6-3.4) underwent trachelectomy. The median age of the trachelectomy group was 31 years (interquartile range, 28-34). The proportion of women who underwent trachelectomy significantly increased during the study period (1.2% in 1998 through 2002, 3.0% in 2003 through 2008, and 4.5% in 2009 through 2014, P < .001). Younger age, nonblack race, single marital status, eastern registry area, recent disease diagnosis, nonsquamous histology, and higher stage were independent factors associated with trachelectomy use (all, adjusted P < .05). After propensity score matching, 5-year cause-specific survival (96.9% vs 96.6%; hazard ratio, 0.73; 95% confidence interval, 0.23-2.30; P = .59) and overall survival (96.1% vs 96.6%; hazard ratio, 0.76; 95% confidence interval, 0.26-2.20; P = .61) were similar between the trachelectomy group and the hysterectomy group. CONCLUSION:Our study found that there was a significant increase in the proportion of reproductive-aged women with stage IA or IB1 (≤2 cm) cervical cancer who underwent trachelectomy in recent years. Survival with trachelectomy was similar to those who had hysterectomy in this population.

SUBMITTER: Machida H 

PROVIDER: S-EPMC6648708 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Characteristics and outcomes of reproductive-aged women with early-stage cervical cancer: trachelectomy vs hysterectomy.

Machida Hiroko H   Mandelbaum Rachel S RS   Mikami Mikio M   Enomoto Takayuki T   Sonoda Yukio Y   Grubbs Brendan H BH   Paulson Richard J RJ   Roman Lynda D LD   Wright Jason D JD   Matsuo Koji K  

American journal of obstetrics and gynecology 20180821 5


<h4>Background</h4>Trachelectomy is the treatment of choice for reproductive-aged women with early-stage cervical cancer who desire future fertility. Comprehensive population-based statistics have been missing to date.<h4>Objective</h4>We sought to compare characteristics and survival of reproductive-aged women who underwent trachelectomy for early-stage cervical cancer to those who had hysterectomy.<h4>Study design</h4>This is a retrospective observational study examining the Surveillance, Epid  ...[more]

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