Abstract
BACKGROUND: Cervical cancer is a prevalent malignancy among women of reproductive age. For early-stage cervical cancer, nerve-sparing radical trachelectomy offers a fertility-preserving treatment option. This procedure aims to remove the cancerous tissue while preserving pelvic nerves necessary for uterine function, thereby maintaining fertility while achieving favorable oncologic outcomes. This study evaluated the obstetric and oncologic outcomes of nerve-sparing radical trachelectomy in patients with early-stage cervical cancer. METHODS: Retrospective reviews were performed on eight patients who underwent nerve-sparing radical trachelectomy for stage IA2-IB1 cervical cancer, classified according to the International Federation of Gynecology and Obstetrics (FIGO). Six patients underwent nerve-sparing radical trachelectomy while preserving the uterine branches of the pelvic nerves, while two patients underwent conventional nerve-sparing radical trachelectomy. Two patients underwent abdominal surgery, and six patients underwent laparoscopic surgeries. The clinical stages included three patients with stage IA2 and five patients with stage IB1. The median follow-up period was 78 months (range, 15-114 months). RESULTS: In this study, 37.5% of the patients attempted conception. The pregnancy rate was 66.7%, with deliveries occurring at full term as well as at 34 gestational weeks. Cine magnetic resonance imaging revealed physiological endometrial movements in patients who underwent surgery. No patient developed recurrence, and none of the patients died. CONCLUSIONS: Early-stage cervical cancer patients may be safe candidates for nerve-sparing radical laparoscopic trachelectomy with preservation of the uterine branches of the pelvic nerves. Maintaining the uterine branches of the pelvic nerves may be crucial for strengthening uterine immunity and maintaining uterine peristalsis, which may contribute to improved pregnancy outcomes.