P331. Pregnancy outcome after radical vaginal trachelectomy with laparoscopic pelvic lymphadenectomy performed as a fertility preservation technique in patients with early-stage cervical cancer

Catalin Bogdan Coroleuca (RO), Ciprian Andrei Coroleuca (RO), Claudia Mehedintu (RO), Costin Berceanu (RO), Diana Mihai (RO), Diana-Elena Comandasu (RO), Cornel Petre Bratila (RO), Elvira Bratila (RO)

[Coroleuca] “Carol Davila” University of Medicine and Pharmacy, Department of Obstetrics and Gynecology, “Panait Sarbu” Clinical Obstetrics Gynecology Hospital, Bucharest, [Coroleuca] “Carol Davila” University of Medicine and Pharmacy, Department of Obstetrics and Gynecology, “Panait Sarbu” Clinical Obstetrics Gynecology Hospital, Bucharest, Romania, [Mehedintu] “Carol Davila” University of Medicine and Pharmacy, Department of Obstetrics and Gynecology, “Nicolae Malaxa” Clinical Emergency Hospital, Bucharest, Romania, [Berceanu] Craiova University of Medicine and Pharmacy, Department of Obstetrics and Gynecology, Xraiova County Hospital, Craiova, [Mihai] “Carol Davila” University of Medicine and Pharmacy, Department of Obstetrics and Gynecology, “Panait Sarbu” Clinical Obstetrics Gynecology Hospital, Bucharest, [Comandasu] “Carol Davila” University of Medicine and Pharmacy, Department of Obstetrics and Gynecology, “Panait Sarbu” Clinical Obstetrics Gynecology Hospital,

Context: Cervical cancer affects women of all ages, but 40 % of early-stage diagnosis are made in women under 45 years. Objective: The objective of this study was to present the oncological, reproductive and obstetric outcomes of patients with early-stage cervical cancer treated with a fertility preservation technique. Methods: Patients underwent sentinel lymph node identification and then radical vaginal trachelectomy with laparoscopic pelvic lymphadenectomy (RVT) was performed using the technique described by D. Dargent. The sentinel lymph node (positive/negative) was used as an intraoperative criteria for conversion to a radical procedure. Patients: This retrospective observational case-control study included 63 patients with early-stage cervical cancer (IA2, IB1) treated with RVT between 2006 – 2017. Inclusion criteria: age under 40 years, early-cervical cancer, express desire to preserve fertility (uterus and menstural function), hyspathological type (scuamos carcinoma or adenocarcinoma) – small cell carcinoma was not included. Main outcome measures: Obstetric outcomes included 14 pregnancies. Mean age after pregnancy was achieved was (2.4 years). Type of conception was spontaneous in 12 cases and IVF in 2 cases. The evolution of the pregnancies was normal in 11 cases: delivery at 38 – 39 weeks of gestation by caesarean section, mean birth weight was 3050 grams. Two of the pregnancies presented as missed abortions at 9 and 10 weeks of gestation. The total detection rate of the sentinel lymph node was 96%, the bilateral detection rate was 92 %, the sensibility was 80 % and the specificity was 96 %. There was 1 case with a false negative result (micrometastasis 1,96 % that received radiotherapy). Results: Radical vaginal trachelectomy with laparoscopic pelvic lymphadenectomy can be used as a safe alternative in selected cases of early-stage cervical in young women who wish to preserve their fertility.