Systematic comparison of radical vaginal trachelectomy and radical hysterectomy in the treatment of early-stage cervical cancer

Objective

To review the effects of radical vaginal trachelectomy (RVT) and radical hysterectomy (RH) on overall progression-free survival rate, and intraoperative and postoperative complications in patients with cervical cancer (FIGO stage IA-IB1).

Methods

Electronic searches for studies of RVT and RH in the treatment of cervical cancer between 1994 and January 2010 were made on MEDLINE, the Cochrane Library, the China National Knowledge Infrastructure, and the Wan Fang dissertation database.

Results

No significant differences were found between RVT and RH in 5-year overall survival rate (relative risk [RR] 0.97; 95% confidence interval [CI], 0.93-1.02); 5-year progression-free survival rate (RR 0.99; 95% CI, 0.95-1.02); intraoperative complications (RR 1.99; 95% CI, 0.61-6.52)]; and postoperative complications (RR 0.36; 95% CI, 0.10-1.27). There were fewer blood transfusions (RR 0.33; 95% CI, 0.12-0.90), less blood loss, and shorter hospital stays in patients undergoing RVT.

Conclusion

Radical vaginal trachelectomy should be considered as a viable treatment option for young patients with early cervical cancer (FIGO stage IA-IB1) who wish to preserve their fertility.