trachelectomy

More women might be similarly blessed if they knew about radical trachelectomy, doctors say.

Recurrence in the residual cervix is very rare if the cancer has been cleared with the trachelectomy.

A radical trachelectomy can be performed abdominally or vaginally and there are conflicting opinions as to which is better.

A radical abdominal trachelectomy with lymphadenectomy usually only requires a two to three day hospital stay, and most women recover very quickly (approximately six weeks).

A radical trachelectomy is surgery that removes the cervix and the pelvic lymph nodes.

A simple trachelectomy refers to the removal of the cervix; this can be considered to be a very large conization procedure.

Cancer has recurred in only about 5 percent of patients who have had radical trachelectomy, the same as occurs with the more drastic radical hysterectomy.

In gynecologic oncology, trachelectomy, also cervicectomy, is a surgical removal of the uterine cervix.

Most patients who try to conceive after radical trachelectomy become pregnant, usually through normal intercourse, although some get an assist from artificial insemination or fertility drugs.

Radical trachelectomy may be a treatment option for some young women with early stages (stage IA2 or IB1) of cervical cancer who hope to preserve their fertility.

Even the most experienced surgeon cannot promise that a trachelectomy can be performed until after surgical microscopic examination, as the extent of the spread of cancer is unknown.

Dr. Allan Covens of the University of Toronto said, "They're not convinced that radical trachelectomy is as good a curative as radical hysterectomy."

Abu-Rustum NR, Su W, Levine DA, et al.: Pediatric radical abdominal trachelectomy for cervical clear cell carcinoma: a novel surgical approach.

The formal name of this operation is radical vaginal trachelectomy (RVT) and also known as the Dargent operation and radical trachelectomy.

"Cervical cancer is a highly curable disease - widespread Pap smear testing detects the cancers early - and American doctors have viewed radical trachelectomy as playing with fire," Dr. Roman said.

"If I had to make this decision again or make it for a family member, I would do the same thing," said Ms. Rivas, who added that she got emotional every year when the anniversary of her radical trachelectomy rolled around.

If a cone biopsy does not produce clear margins (findings on biopsy showing that the tumor is surrounded by cancer free tissue, suggesting all of the tumor is removed), one more possible treatment option for patients who want to preserve their fertility is a trachelectomy.

Through a network of family friends, she was put in touch with Dr. Lynda Roman, a gynecologic oncologist at the University of Southern California, who offered her an unconventional alternative operation - radical trachelectomy - that could effectively treat her disease while preserving her fertility.