Perioperative Safety, Surgical Margins, and Disease-Free Survival After Abdominal Radical Trachelectomy for Fertility Preservation in Early-Stage Cervical Cancer: A Single-Center Cohort Study in Vietnam

Background/Objectives: Abdominal radical trachelectomy (ART) preserves fertility in early-stage cervical cancer, but little is known about its outcomes outside North America, Western Europe, and East Asia. We report complications, surgical margins, and disease-free survival (DFS) in the first ART cohort from Vietnam. Methods: In this single-center retrospective cohort study, 21 consecutive patients with FIGO 2018 stage IA1–IB1 cervical cancer (tumor ≤2 cm) underwent ART with fertility-preserving intent. Complications were graded by the Clavien–Dindo system and DFS was estimated by the Kaplan–Meier method. Given the small sample, exact 95% confidence intervals and the rule of three were used. Results: No intraoperative complication occurred (0/21; 95% CI 0.0–16.1%). Five patients (23.8%) had a complication within 30 days, mostly grade II, and two (9.5%) had a grade IIIb complication. The endocervical margin was positive in one patient (4.8%). Median follow-up was 39 months (IQR 19–73). No recurrence or death occurred, and DFS was 100% at 1, 3, and 5 years, although only 7/21 patients had reached 5 years. Conclusions: In this selected cohort, ART had acceptable early safety and no recurrences. With wide confidence intervals and immature 5-year data, the findings show feasibility but do not prove safety.