Conservative excisional laser conization for early invasive cervical cancer.
OBJECTIVE
To investigate the possibility of conservative excisional laser conization for early invasive cervical cancer.


METHODS
Four hundred one women with early invasive squamous cell cancer were treated by laser conization and semiradical or radical hysterectomy with pelvic lymphadenectomy. Their histologic findings and clinical outcomes were evaluated retrospectively.


RESULTS
Two hundred Ia1 cases without confluent invasion or vessel permeation receiving only laser therapy had no recurrent disease. There was no lymph node metastasis in 123 Ia1 and 24 Ia2 cases with stromal invasion of under 4 mm in depth regardless of confluent invasion and vessel permeation. However, lymph node metastasis was detected in 1 of 13 Ia2 cases with stromal invasion of over 4 mm in depth and in 5 of 41 Ib1 cases. All of these six cases had vessel permeation in the resected specimens.


CONCLUSIONS
Conservative excisional laser conization may be possible for stage Ia cervical cancer with stromal invasion of under 4 mm in depth. However, the risk of lymph node metastasis should be still considered for those lesions with vessel permeation.
Ueda
Masatsugu
M
Department of Obstetrics and Gynecology, Osaka Medical College, Takatsuki, Osaka 569-8686, Japan. gyn017@poh.osaka-med.ac.jp
Ueki
Ken
K
Kanemura
Masanori
M
Izuma
Shinji
S
Yamaguchi
Hiroyuki
H
Terai
Yoshito
Y
Ueki
Minoru
M
D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D019092:Conization / Q000379:methods*; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery*