DISKUSSIONNYE VOPROSY AD\"YuVANTNOY TERAPII PRI ORGANOSOKhRANYaYuShchEM LEChENII INVAZIVNOGO RAKA ShEYKI MATKI



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Abstract

Organ-saving treatment for invasive cervical cancer, by applying radical trachelectomy, is as effective as radical hysterectomy. Despite careful selection of patients, there are indications for adjuvant treatment in an average of 10% of cases. The conventional approach for this category of patients is to use radiation or chemoradiation, which leads to irreversible fertility loss. There have been some cases when chemotherapy was employed as an alternative adjuvant therapy after radical trachelectomy or the patients followed up were untreated; however, data on the efficiency of these approaches are yet inadequate. The problem whether adjuvant treatment is performed after radical trachelectomy remains debatable calls for further studies.
Since December 2005, the P.A. Herzen Moscow Research Oncological Institute has been performing radical abdominal trachelectomy (RAT), developed an original procedure for saving the uterine vessels. Modified trachelectomy was carried out in 72 patients; in 9 (12.5%) of them, the surgical volume was extended to radical hysterectomy with ovarian transposition from the data of a prompt histological study. A scheduled histological study after RAT revealed metastases to the pelvic lymph nodes in 4 (6%) of 63 patients. Thus, radical organ-saving treatment could be performed in 59 (82%) of the 72 patients selected for trachelectomy according to the results of a preoperative examination.

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