Questionnaire survey of the current status of radical trachelectomy in Japan

Background: The number of young patients with cervical cancer has been increasing recently in Japan. Radical trachelectomy is a potential option for patients who wish to preserve their fertility, but its status is not clear. The present survey was conducted to clarify the status of radical trachelectomy in Japan. Methods: Questionnaires were mailed to 164 selected institutions based on tumor registration with the Japanese Obstetrics Gynecology Society. The subjects were patients undergoing radical trachelectomy between 2000 and 2008. Results: The response rate to the questionnaire was 88.4% (145/164). Radical trachelectomy was performed on 269 patients in 26 institutions (17.9%). Most cases (74.7%, 201/269) underwent an abdominal approach. Three institutions had performed more than 21 cases (max. 61 cases), whereas 8 institutions had performed only one case. Twenty pregnancies and 13 deliveries were achieved and the frequency of delivery later than the 29th gestational week was 62% (8/13). "Tumor size ≤2 cm (81%)" and "stage ≤Ib1 (96%)" were commonly regarded as indications for radical trachelectomy. On the other hand, 46% of the centers did not consider the histological type as an indication. Conclusion: This survey is the first report on the current status of radical trachelectomy in Japan. It reveals a difference in the criteria for surgery applied in each institution.