Curr Opin Obstet Gynecol. 2006 Feb;18(1):8-13.
Radical trachelectomy with laparoscopic lymphadenectomy: review of oncologic and obstetrical outcomes.
Burnett AF.
Chief, Division of Gynecologic Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
PURPOSE OF REVIEW: Fertility preservation in early cervical cancer by radical trachelectomy is gaining in acceptance as more cases are published in the literature. Controversies regarding technique and patient management are beginning to emerge as the procedure moves from being a new surgery to a part of standard of care. RECENT
Findings:
As the number of cases reported in the literature increases, the effectiveness of radical trachelectomy for treating selected early-stage cancers continues to gain support. The survival of selected patients appears to be no different than that of similar patients treated with radical hysterectomy. Central recurrence in the residual cervix is a very rare event as long as the specimen has cleared the cancer. Patient selection criteria have evolved, and a more liberal use of the procedure is warranted. The effectiveness of trachelectomy in preserving fertility has now been demonstrated in series of 50 and 56 pregnancies occurring after the procedure. These larger series detail pregnancy outcomes and will be invaluable information to our patients who wish to maintain their ability to bear children. Subtle differences in technique between centers may account for different pregnancy outcomes. As more physicians begin to perform radical trachelectomy, controlled trials will be necessary to refine the procedure in order to continue to improve obstetric and oncologic outcomes. SUMMARY: Radical trachelectomy will continue to increase in popularity as more physicians become willing to learn the technique. It should routinely be offered to young women with early cervix cancer who desire to maintain their fertility.
Please click on the required question.
- 1 What is cancer (malignancy)
- 2 What is meant by cancer staging?
- 3 How prevalent is cancer?
- 4 How prevalent are womens' cancers?
- 5 What causes cancer?
- 6 Is cancer a hereditary condition?
- 7 How can gynaecological cancer present?
- 8 How can we reduce the risks of the womens' cancers?
Reducing the Risks of Womens' Cancers.
- 9 What are screening tests?
- 10 What are the reactions to a diagnosis of cancer?
- 11 Is there a place for counselling when cancer is diagnosed?
- 12 Can personality alter the prognosis?
- 13 Is the incidence of deaths from the female cancers changing?
- 14 Is there a place for a holistic approach to cancer?
Cancer of the Cervix.
- 15 How prevalent is cervical cancer?
- 16 What causes cervical cancer?
- 17 How long an interval should there be between cervical screening (smear) (PAP) tests?
- 18 Is there any evidence that cervical screening can reduce the incidence of cervical cancer?
- 19 Will pre-malignant changes of the cervix invariably lead to cancer?
Endometrial Cancer (Uterus)
- 20 What causes endometrial cancer?
- 21 Are there screening tests for endometrial cancer?
- 22 How does endometrial cancer present?
Cancer of the Ovary.
- 23 How does ovarian cancer present?
- 24 How prevalent is ovarian cancer?
- 25 What are tumour markers?
- 26 Can we screen for ovarian cancer?
- 27 What is the relationship between infertility and ovarian cancer?
- 28 Can treatment of infertility increase the risk of ovarian cancer?
- 29 What is the relationship between oral contraception and cancer?
- 30 Can ovarian cancer be prevented?
- 31 I use talcum power. Could this increase my risk of developing ovarian cancer?
The Treatment Of Womens' Cancers
- 14 Is there a place for a holistic approach to cancer?
- 32 Can we predict the course of a cancer?
- 33 What treatment options are available for gynaecological cancer?
- Q32.33c What treatment options are available for ovarian cancer?
Cancer of the Vulva, Vagina and Fallopian Tube
- 34 How prevalent are malignant conditions of the vulva, vagina and Fallopian tubes?
Breast Cancer
- 35 What is the incidence of breast cancer?
- 35 ?What is the cause of breast cancer?
- 35a What are the advantages of breast cancer screening - mammography - mammograms?
- 36 How often should breast screening be carried out?
- 37 Are there any problems having a mammogram?
- 38 Should I check myself for breast lumps?
- 39 One of my family developed cancer of the breast. Am I at increased risk?
- 40 We have a family tendency towards developing breast / ovarian cancer. Are there any genetic tests to find out if I am at increased risk?
- 41 What happens if a mammogram shows an abnormality?
- 42 What are the advantages and disadvantages of tamoxifen in the management of breast cancer?
- 42a Breast Cancer Treatment - What is available?
- 43 What is the relationship between breast cancer and the pill?
Web sites and Support Groups
- 44 Are there any support groups?
- 44 Are there any support groups?
- 45 Support Groups.
- 46 Breast Cancer Support Groups
- 47 Ovarian Cancer Support Groups
- 48 Endometrial Cancer Support Groups
- 49 Cervical Cancer Support Groups
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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
