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Uterus & cervix: embryological one unit
•
interconnected lymphatics
•
no separating fascial plane
Challenging to determine myometrial invasion
Trachelectomy, early stage disease
a
:
•
Local recurrence < 5 %, Mortality < 3%
•
Uterine recurrences
b,c,d
2 %
Trachelectomy, tumor > 2 cm or lymphovascular invasion
a,e
:
•
Local recurrence up to 10 %
Allowing for some dose reduction to the fundus in cases
without uterine infiltration will be investigated in future
Lim K, et al. IJROBP 2010
a
Plante M. Gynecol Oncol 2008
b
Bali A, et al. Gynecol Oncol 2008
c
Diaz JP, et al. Gynecol Oncol 2008
d
Hertel H, et al. Gynecol Oncol 2006
e
Nishio H, et al. Gynecol Oncol 2009
Why the entire uterus?
Rationale