Pathological indications for conservative therapy in treating cervical cancer.
BACKGROUND
Neodymium-ytlium, argon, gadolinium (Nd-YAG) laser conization was performed in 366 patients with carcinoma in situ (CIS), and 198 with microinvasive carcinoma (MIC), and 29 with early invasive cancer (IC). The diagnostic accuracy was 72.5% in the CIS group, and 74.6% in the MIC and early IC group.


RESULTS
All of the patients who obtained complete excision are now alive and doing well following the conization, with no evidence of recurrence of the disease. Incomplete excision was found in 21.7% of the MIC, 50.0% of the IC with 3 mm or less invasion, 22.2% of the IC with 3.1-4 mm, 60.0% of the IC with 4.1-5 mm invasion, 100% of the IC with 5 mm or more invasion. The residual rate of the MIC and IC with 4 mm or less invasion was 8.5%, lower than 62.5% of the IC with 4.1-5 mm invasion. The cure rate by conization in the patients with IC of 4.0 mm or less was much higher than that in the patients with IC of over 4.1 mm.


CONCLUSIONS
These results suggested that the indication of laser conization for early IC was the case within 4 mm invasion, completely excised.
Okamoto
Y
Y
Department of Obstetrics and Gynecology, Osaka Medical College, Takatsuki, Japan.
Ueki
K
K
Ueki
M
M
D000328:Adult; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D019092:Conization; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D053685:Laser Therapy; D008197:Lymph Node Excision; D018365:Neoplasm, Residual / Q000453:epidemiology / Q000601:surgery; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery*