Cervical cancer surgery allows for pregnancy

NEW YORK June 21 (Reuters) An operation called radical vaginal trachelectomy is an effective treatment for early cervical cancer that allows women to become pregnant later on, according to a report in the medical journal BJOG.

Cervical cancer is a common cancer among women, strongly related to infection with certain types of human papilloma virus or HPV.

Earlier this month, the US Food and Drug Administration approved the first vaccine to target four of the HPV types commonly linked to cervical cancer.

Unlike hysterectomy, radical vaginal trachelectomy involves removal of only the cervix, not the entire uterus. As such, the operation is only recommended for early cancer that has not yet spread outside the cervix. In theory, women treated with the operation could still become pregnant, yet few studies have actually looked at the pregnancy outcomes of these women.

The new findings indicate that while there are few complications, women who undergo the procedure have higher than normal rates of premature labor and miscarriage.

The findings are based on a study of 123 consecutive women with early cervical cancer who underwent radical vaginal trachelectomy.

The procedures were performed between August 1994 and 2005 and the average follow-up period was 45 months.

The operation effectively prevented the return of cancer in all but five women, senior author Dr. Thomas E J Ind, from St George's Hospital in London, and colleagues report.

A total of 55 pregnancies were achieved among the 63 women who attempted to become pregnant, but only 28 live births occurred. The 5-year cumulative pregnancy rate for women attempting to conceive was 52.8 per cent.

All but two of the live births occurred via cesarean section and thirteen of the infants were born prematurely.

The results indicate that radical vaginal trachelectomy is a pregnancy-enabling option for women with early cervical cancer, but prospective patients should be aware of the high rates of miscarriage and premature labor, the authors conclude.

REUTERS SY BD0936