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OBJECTIVE: This study aimed to report on a series of patients with early-stage cervical cancer who underwent an abdominal radical trachelectomy to preserve their fertility. MATERIALS AND METHODS: We performed a retrospective review of all patients who underwent an abdominal radical trachelectomy in 2 centers of gynecologic oncology in Argentina. Data collected included patient's age, stage, histologic subtype, tumor grade, tumor size, evidence of lymph vascular space invasion, number of lymph nodes removed, perioperative complications, as well as oncologic and obstetrical outcomes. RESULTS: Thirty patients were selected for radical trachelectomy. Five of these patients were excluded from the study: 3 for compromised margins, 1 for lymph node involvement, and 1 for vesicovaginal space involvement. Twenty-five patients underwent the procedure and were included in this report. Median age was 31 years (range = 22-40 years). Nineteen patients had stage IB1, and 6 patients had stage IA2 cervical cancer. Median tumor size was 1.2 cm (range = 0.4-3.5 cm). Median number of pelvic lymph nodes removed was 21 (range = 11-33). Median surgical time was 240 minutes (range = 210-270 minutes), and median length of hospital stay was 3.5 days (range = 3-5 days). Estimated blood loss was 350 mL (range = 200-700 mL). No intraoperative complications were reported. There were 6 postoperative complications. Three patients (12%) were able to get pregnant spontaneously with 3 live births by cesarean delivery. No recurrences were reported with a median follow-up of 29.6 months. CONCLUSIONS: Abdominal radical trachelectomy with pelvic lymphadenectomy is a feasible procedure and a viable option for women wishing to preserve their fertility in developing countries.

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Over the years, the treatment of breast cancer has changed dramatically. We briefly describe those changes and also the different therapeutic approches to the axillary nodes. Over the last century, the primary goal was to avoid radical surgery of the breast. However, during the last decades, the interest was mainly focused on the possibility of treating the axila in a conservative way, in an effort to minimize the adverse effects of linfadenectomy. The sentinel node technique is of key importance, because nowadays it is possible to diagnose breast cancer at early stages when most of the times the axila is negative. The early diagnoses of breast cancer makes the sentinel node technique a relevant tool at the time of making therapeutic decisions. We believe that the sentinel node technique could predict in many cases the lymph node status without the need of a complete axillary dissection of the axila in patients with breast cancer.

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El tratamiento del cáncer de mama (CM), tumor mas frecuente en la mujer, sufrió diferentes modificaciones a lo largo de los dos últimos siglos. Se describe una reseña de las mismas, como así también los cambios en el manejo de la terapéutica axilar. Durante el siglo pasado, se trabajó fundamentalmente en las opcionesterapéuticas para la conservación de la glándula mamaria. Recién en las últimas décadas comienza el planteo de conductas dirigidas al manejo conservador de la axila, sobre todo para minimizar los efectos adversos secundarios a la linfadenectomía axilar completa. La técnica del Ganglio Centinela cobra importancia ya que los canceres de mama, cada vez con mayor frecuencia, son diagnosticados en estadios iniciales, por lo que las probabilidades de tener ganglios axilares negativos son cada vez mayores. Concluimos que la información que brinda el conocimiento del estado de los ganglios axilares es muy importante en la toma de decisiones terapéuticas en pacientes con cáncer de mama, y que la técnica del ganglio centinela podría, en algunos casos, ser un test que predice el status ganglionar axilar, sin necesidad de realizar una linfadenectomía axilar clásica.

Over the years, the treatment of breast cancer has changed dramatically. We briefly describe those changes and also the different therapeutic approaches to the axillary nodes. Over the last century, the primary goal was to avoid radical surgery of the breast. However, during the last decades, the interest was mainly focused on the possibility of treating the axilla in a conservative way, in an effort to minimize the adverse effects of linfadenectomy. The sentinel node technique is of key importance, because nowadays it is possible to diagnose breast cancer at early stages when most of the times the axilla is negative. The early diagnoses of breast cancer make the sentinel node technique a relevant tool at the time of making therapeutic decisions. We believe that the sentinel node technique could predict in many cases the lymph node status without the need of a complete axillary dissection of the axilla in patients with breast cancer.

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El tratamiento del cáncer de mama (CM), tumor mas frecuente en la mujer, sufrió diferentes modificaciones a lo largo de los dos últimos siglos. Se describe una reseña de las mismas, como así también los cambios en el manejo de la terapéutica axilar. Durante el siglo pasado, se trabajó fundamentalmente en las opcionesterapéuticas para la conservación de la glándula mamaria. Recién en las últimas décadas comienza el planteo de conductas dirigidas al manejo conservador de la axila, sobre todo para minimizar los efectos adversos secundarios a la linfadenectomía axilar completa. La técnica del Ganglio Centinela cobra importancia ya que los canceres de mama, cada vez con mayor frecuencia, son diagnosticados en estadios iniciales, por lo que las probabilidades de tener ganglios axilares negativos son cada vez mayores. Concluimos que la información que brinda el conocimiento del estado de los ganglios axilares es muy importante en la toma de decisiones terapéuticas en pacientes con cáncer de mama, y que la técnica del ganglio centinela podría, en algunos casos, ser un test que predice el status ganglionar axilar, sin necesidad de realizar una linfadenectomía axilar clásica.(AU)

Over the years, the treatment of breast cancer has changed dramatically. We briefly describe those changes and also the different therapeutic approaches to the axillary nodes. Over the last century, the primary goal was to avoid radical surgery of the breast. However, during the last decades, the interest was mainly focused on the possibility of treating the axilla in a conservative way, in an effort to minimize the adverse effects of linfadenectomy. The sentinel node technique is of key importance, because nowadays it is possible to diagnose breast cancer at early stages when most of the times the axilla is negative. The early diagnoses of breast cancer make the sentinel node technique a relevant tool at the time of making therapeutic decisions. We believe that the sentinel node technique could predict in many cases the lymph node status without the need of a complete axillary dissection of the axilla in patients with breast cancer.(AU)

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La investigación del ganglio centinela es un test diagnótico que podría, en algunos casos evitar la disección axilar y sus complicaciones en estadios iniciales de cancer de mama.En 111 casos obtuvimos 182 ganglios centinelas con un promedio de 1,65 ganglio por paciente.De los 182 ganglios, 97,4 % se localizaban en axila, 2,1 % en mamaria interna y 0,5 % interpectoral (Rotter)

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La investigación del ganglio centinela es un test diagnótico que podría, en algunos casos evitar la disección axilar y sus complicaciones en estadios iniciales de cancer de mama.En 111 casos obtuvimos 182 ganglios centinelas con un promedio de 1,65 ganglio por paciente.De los 182 ganglios, 97,4 % se localizaban en axila, 2,1 % en mamaria interna y 0,5 % interpectoral (Rotter)

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