title: Prognostic factors in microinvasive cervical squamous cell cancer: long-term results.
abstract: We examined tumor-related pathologic factors and cone-related characteristics to identify parameters related to recurrence in microinvasive squamous cell carcinoma of the cervix treated with conization. This is a retrospective study on 67 consecutive cases of microinvasive carcinoma of the cervix [depth of invasion (DI) < 3 mm] treated with conization. The mean follow-up was 121 months (range 72-276 months). Four (6%) invasive recurrences were observed. Presence of lymphvascular space involvement (LVSI) was significantly related with recurrences (P < 0.05). The mean distance between tumor margin and apex of the cone (apical clearance) was 10.6 mm (range 5-22 mm), and the mean distance between lateral border of the cone and tumor margin (lateral clearance) was 6.5 mm (range 1.7-15 mm). We adopted cut-off values of 10 and 8 mm for apical and lateral clearances, respectively. We found a statistically significant difference between apical clearance and recurrence rate (P < 0.02). The LVSI was, other than DI, an important prognostic factor. Apical clearance was significantly correlated with recurrence. The cone-related characteristics, other than tumor-related pathologic factors, could help the decision concerning the definitive therapy for microinvasive carcinoma of the cervix.
authors.affiliation: Department of Gynecology/Oncology, Istituto per lo Studio e la Cura dei Tumori, Via Venezian 1, 20133 Milan, Italy. francesco.raspagliesi@istitutotumori.mi.it
authors.forename: F
authors.initials: F
authors.lastname: Raspagliesi
authors.forename: A
authors.initials: A
authors.lastname: Ditto
authors.forename: P
authors.initials: P
authors.lastname: Quattrone
authors.forename: E
authors.initials: E
authors.lastname: Solima
authors.forename: R
authors.initials: R
authors.lastname: Fontanelli
authors.forename: V
authors.initials: V
authors.lastname: Dousias
authors.forename: S
authors.initials: S
authors.lastname: Kusamura
authors.forename: M L
authors.initials: ML
authors.lastname: Carcangiu
mesh_terms: D000328:Adult; D002278:Carcinoma in Situ / Q000473:pathology* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D002584:Cervix Uteri / Q000473:pathology / Q000601:surgery*; D019092:Conization; D003944:Diagnostic Techniques, Obstetrical and Gynecological; D005260:Female; D006801:Humans; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery