The efficacy of conservative management after conization in patients with stage IA1 microinvasive cervical carcinoma.
OBJECTIVE
To investigate the efficacy of conization followed by conservative management for treating stage IA1 microinvasive carcinoma of the uterine cervix.


METHODS
Retrospective study.


METHODS
Seventy-five patients treated for stage IA1 microinvasive carcinoma of the cervix. Patients underwent conization followed by hysterectomy (Group 1, 53 patients), or were followed by conservative management (Group 2, 22 patients).


METHODS
Medical and histopathological record review.


RESULTS
For Group 1, pathology results showed that 30 had no residual tumor, one had cervical intraepithelial neoplasia (CIN) I, 11 had CIN III/cervical carcinoma in situ (CIS), nine had microinvasive carcinomas, and one had an invasive carcinoma (outcome for one patient not recorded). For Group 2, secondary procedures involved only cervical smears for 12 (48%) patients, of whom nine had normal cytology, one had low-grade squamous intraepithelial lesion and two had high-grade squamous intraepithelial lesions. For 13 (52%) patients in Group 2, secondary procedures involved repeat conization on whom six had no residual tumor, one had CIN II, four CIN III/CIS, and two microinvasive carcinoma and a negative resection margin. Therefore, conization followed by conservative management was an effective treatment for 90.9% (20/22) of Group 2. In neither group was recurrence recorded. There was no relation between lymphovascular invasion and follow-up cytology or pathology results, or between resection margin status and follow-up examination results.


CONCLUSIONS
Conization alone with careful follow-up appears to be an effective and safe treatment for patients with stage IA1 microinvasive carcinoma of the uterine cervix, regardless of resection margins status or lymphovascular invasion.
Lee
Shin Wha
SW
Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
Kim
Yong-Man
YM
Son
Woo-Seok
WS
You
Hang-Jo
HJ
Kim
Dae-Yeon
DY
Kim
Jong-Hyeok
JH
Kim
Young-Tak
YT
Nam
Joo-Hyun
JH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D002584:Cervix Uteri / Q000473:pathology / Q000601:surgery*; D019092:Conization; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery*