Radical Trachelectomy

Fertility Problems for Cervical Cancer Patients

In the past, a diagnosis of early stage invasive cervical cancer would usually lead to infertility because of the recommended treatment necessary to cure the cancer. Treatment typically includes a radical hysterectomy and sometimes radiation therapy and/or chemotherapy. Over the past decade, there has been an increased focus towards fertility preservation in the treatment of cervical cancer since a little less than half of all women diagnosed with cervical cancer are 45 years old or younger.

Traditionally, women diagnosed with cervical cancer were offered fertility preserving options such as embryo freezing, with vitro fertilization (IVF), and ovarian transposition, where ovaries are moved away from the target zone for radiation therapy treatment.  But these measures only preserve a woman’s eggs; because of the radical hysterectomy, she is unable to carry the child and must use a surrogate.

New Fertility Preserving Option – the Radical Trachelectomy

But a new option, the radical trachelectomy, gives certain women the option of carrying their child to term after treatment for cervical cancer.

Developed in France by Daniel Dargent, MD, in 1995, the radical trachelectomy is a complex surgical procedure that removes:

  • the cervix
  • parametrium, or the tissue adjacent to the cervix
  • pelvic lymph nodes
  • a portion of the vagina

and then connects the uterus to the vagina. A cerclage is also performed, which is a procedure that involves sewing the opening of the uterus closed to prevent preterm labor if a patient does become pregnant.

There are certain criteria a patient must meet in order to be considered for a radical trachelectomy, including:

  • being less than 40 years old with a strong desire to preserve fertility
  • no clinical signs of impaired fertility
  • stage IA-IB1 cervical cancer that shows no signs that it has spread.

Good Success Rates

Although more complicated, the success rate of the procedure for treating cervical cancer is equivalent to that of a radical hysterectomy. In addition, according to a study by the MD Anderson Cancer Center, of patients around the world treated with a radical trachelectomy, about half have tried to become pregnant and of those, roughly 60 percent have delivered full-term babies via cesarean section.
To learn more, call Cancer Services at 770-219-8800.