First birth after uterine transposition in low-volume lymph node metastasis of cervical cancer: A long journey for success
Corresponding Author
Renato Moretti-Marques MD, PhD
Department of Gynecological Oncology, Hospital Israelita Albert Einstein, Sao Paulo City, Sao Paulo, Brazil
Correspondence Renato Moretti-Marques, MD, PhD, Av. Albert Einstein 627, São Paulo City 05652-900, Brazil.
Email: [email protected]
Search for more papers by this authorIve Bahia Franca MD
Department of Gynecological Oncology, Hospital Israelita Albert Einstein, Sao Paulo City, Sao Paulo, Brazil
Search for more papers by this authorPedro Ernesto de Cillo MD
Department of Gynecological Oncology, Hospital Israelita Albert Einstein, Sao Paulo City, Sao Paulo, Brazil
Search for more papers by this authorVanessa Alvarenga-Bezerra MD, MSc
Department of Gynecological Oncology, Hospital Israelita Albert Einstein, Sao Paulo City, Sao Paulo, Brazil
Search for more papers by this authorJuliana Karassawa Helito MD
Department of Gynecological Oncology, Hospital Israelita Albert Einstein, Sao Paulo City, Sao Paulo, Brazil
Search for more papers by this authorDonato Callegaro Filho MD, PhD
Department of Gynecological Oncology, Hospital Israelita Albert Einstein, Sao Paulo City, Sao Paulo, Brazil
Search for more papers by this authorNam Jin Kim MD
Department of Gynecological Oncology, Hospital Israelita Albert Einstein, Sao Paulo City, Sao Paulo, Brazil
Search for more papers by this authorReitan Ribeiro MD
Department of Gynecological Oncology, Hospital Erasto Gaertner, Curitiba, Brazil
Search for more papers by this authorCorresponding Author
Renato Moretti-Marques MD, PhD
Department of Gynecological Oncology, Hospital Israelita Albert Einstein, Sao Paulo City, Sao Paulo, Brazil
Correspondence Renato Moretti-Marques, MD, PhD, Av. Albert Einstein 627, São Paulo City 05652-900, Brazil.
Email: [email protected]
Search for more papers by this authorIve Bahia Franca MD
Department of Gynecological Oncology, Hospital Israelita Albert Einstein, Sao Paulo City, Sao Paulo, Brazil
Search for more papers by this authorPedro Ernesto de Cillo MD
Department of Gynecological Oncology, Hospital Israelita Albert Einstein, Sao Paulo City, Sao Paulo, Brazil
Search for more papers by this authorVanessa Alvarenga-Bezerra MD, MSc
Department of Gynecological Oncology, Hospital Israelita Albert Einstein, Sao Paulo City, Sao Paulo, Brazil
Search for more papers by this authorJuliana Karassawa Helito MD
Department of Gynecological Oncology, Hospital Israelita Albert Einstein, Sao Paulo City, Sao Paulo, Brazil
Search for more papers by this authorDonato Callegaro Filho MD, PhD
Department of Gynecological Oncology, Hospital Israelita Albert Einstein, Sao Paulo City, Sao Paulo, Brazil
Search for more papers by this authorNam Jin Kim MD
Department of Gynecological Oncology, Hospital Israelita Albert Einstein, Sao Paulo City, Sao Paulo, Brazil
Search for more papers by this authorReitan Ribeiro MD
Department of Gynecological Oncology, Hospital Erasto Gaertner, Curitiba, Brazil
Search for more papers by this authorAbstract
Locally advanced cervical cancer poses a significant challenge to fertility-sparing treatments. Pelvic radiotherapy impairs reproductive potential owing to ovarian, uterine, and endometrial side effects. This study presents a literature review of the main fertility-sparing therapeutic alternatives for locally advanced cervical cancer and a case report of the first childbirth following uterine transposition for gynecological malignancies.
CONFLICT OF INTEREST STATEMENT
The authors declare no conflict of interest.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
REFERENCES
- 1 WHO. Cervical Cancer. WHO; 2023. https://www.who.int/news-room/fact-sheets/detail/cervical-cancer
- 2Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021; 71: 209-249.
- 3Cibula D, Pötter R, Planchamp F, et al. The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology Guidelines for the Management of Patients With Cervical Cancer. Int J Gynecol Cancer. 2018; 28: 641-655.
- 4Larsen EC, Schmiegelow K, Rechnitzer C, Loft A, Müller J, Nyboe Andersen A. Radiotherapy at a young age reduces uterine volume of childhood cancer survivors. Acta Obstet Gynecol Scand. 2004; 83: 96-102.
- 5Wallace WHB, Thomson AB, Saran F, Kelsey TW. Predicting age of ovarian failure after radiation to a field that includes the ovaries. Int J Radiat Oncol Biol Phys. 2005; 62: 738-744.
- 6Ribeiro R, Rebolho JC, Tsumanuma FK, Brandalize GG, Trippia CH, Saab KA. Uterine transposition: technique and a case report. Fertil Steril. 2017; 108: 320-324.
- 7Baiocchi G, Mantoan H, Chen MJ, Faloppa CC. Uterine transposition after radical trachelectomy. Gynecol Oncol. 2018; 150: 387-388.
- 8Moretti-Marques R, Tsunoda AT, Dias RS, Pimenta JM, Linhares JC, Ribeiro R. Robotic uterine transposition for a cervical cancer patient with pelvic micrometastases after conization and pelvic lymphadenectomy. Int J Gynecol Cancer. 2020; 30: 898-899.
- 9Baiocchi G, Vieira M, Moretti-Marques R, et al. Uterine transposition for gynecological cancers. Int J Gynecol Cancer. 2021; 31: 431-435.
- 10Roma AA, Mistretta T-A, De Vivar AD, et al. New pattern-based personalized risk stratification system for endocervical adenocarcinoma with important clinical implications and surgical outcome. Gynecol Oncol. 2016; 141: 36-42.
- 11Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R. Cancer of the cervix uteri: 2021 update. Int J Gynecol Obstetr. 2021; 155(suppl 1): 28-44.
- 12Olawaiye AB, Baker TP, Washington MK, Mutch DG. The new (Version 9) American Joint Committee on Cancer tumor, node, metastasis staging for cervical cancer. CA Cancer J Clin. 2021; 71: 287-298.
- 13Floyd JL, Campbell S, Rauh-Hain JA, Woodard T. Fertility preservation in women with early-stage gynecologic cancer: optimizing oncologic and reproductive outcomes. Int J Gynecol Cancer. 2021; 31: 345-351.
- 14Jones BP, Kasaven L, Vali S, et al. Uterine transplantation: review of livebirths and reproductive implications. Transplantation. 2021; 105: 1695-1707.
- 15Ribeiro R, Baiocchi G, Obermair A, Costa CN, Leitao M. Uterine transposition for fertility preservation in pelvic cancers. Int J Gynecol Cancer. 2024; 34: 403-408.
- 16Smith ES, Moon AS, O'Hanlon R, et al. Radical trachelectomy for the treatment of early-stage cervical cancer: a systematic review. Obstetr Gynecol. 2020; 136: 533-542.
- 17Delomenie M, Bonsang-Kitzis H, Bats A-S, et al. The clinical implication of lymph nodes micrometastases and isolated tumor cells in patients with cervical cancer: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2019; 241: 71-76.
- 18Kocian R, Slama J, Fischerova D, et al. Micrometastases in sentinel lymph nodes represent a significant negative prognostic factor in early-stage cervical cancer: a single-institutional retrospective cohort study. Cancers. 2020; 12:1438. doi:10.3390/cancers12061438
- 19Guani B, Mahiou K, Crestani A, et al. Clinical impact of low-volume lymph node metastases in early-stage cervical cancer: a comprehensive meta-analysis. Gynecol Oncol. 2022; 164: 446-454.
- 20Odetto D, Saadi JM, Chacon CB, Wernicke A, Ribeiro R. Uterine transposition after radical trachelectomy. Int J Gynecol Cancer. 2021; 31: 1374-1379.
- 21Chernyshova A, Marchenko E, Chekalkin T, Kolomiets L, Chernov V. Performing a radical trachelectomy with uterine transposition in a patient with stage IB2 cervical cancer: a case report. Cancer Treat Res Commun. 2023; 34:100681.
- 22Li X, Li J, Wu X. Incidence, risk factors and treatment of cervical stenosis after radical trachelectomy: a systematic review. Eur J Cancer. 2015; 51: 1751-1759.
- 23Ribeiro R, Anselmi MC, Schneider GA, Rodrigues Furtado JP, Mohamed Abau Shwareb MG, Linhares JC. First live birth after uterine transposition. Fertil Steril. 2023; 120: 188-193. doi:10.1016/j.fertnstert.2023.02.033
- 24Nezhat C, Roman RA, Rambhatla A, Nezhat F. Reproductive and oncologic outcomes after fertility-sparing surgery for early stage cervical cancer: a systematic review. Fertil Steril. 2020; 113: 685-703.
- 25Shennan A, Chandiramani M, Bennett P, et al. MAVRIC: a multicenter randomized controlled trial of transabdominal vs transvaginal cervical cerclage. Am J Obstet Gynecol. 2020; 222:261.