Conization using electrosurgical conization and cold coagulation for international federation of gynecology and obstetrics stage IA1 squamous cell carcinomas of the uterine cervix.
OBJECTIVE
This study was performed to evaluate the efficacy and feasibility of electrosurgical conization and cold coagulation as definitive treatments for patients with International Federation of Gynecology and Obstetrics stage IA1 squamous cell carcinoma of the cervix and a resection margin free from (micro)invasive carcinoma after conization.


METHODS
Patients with stage IA1 cervical squamous cell carcinoma without lymphovascular space invasion who had been treated by electrosurgical conization and cold coagulation and who wanted to preserve fertility (or only undertake conservative treatment) were followed up without further surgical intervention. Patients with invasive or microinvasive carcinoma at resection margins or positive endocervical resection margins were excluded from the study. Cervicovaginal smears and colposcopic examination were performed at regular intervals. Disease recurrence was defined as a histologic diagnosis of cervical intraepithelial neoplasia 2 or higher-grade lesions.


RESULTS
A total of 85 patients enrolled were deemed eligible to be involved in the study. The median follow-up period was 81.0 months (range, 13-127 months). Nineteen of the 85 patients had exocervical resection margins. There was one case of recurrence, which was node-positive invasive cancer recurrence (1.2%, 1/85), in patients with negative resection margins.


CONCLUSIONS
These results suggest that electrosurgical conization with cold coagulation is a feasible treatment and could be used as a definitive therapy for patients with stage IA1 cervical squamous cell carcinoma without lymphovascular space invasion. In addition, patients having cervical intraepithelial neoplasias 2 and 3 at exocervical resection margins could be followed up carefully without further treatment after conization and cold coagulation.
Lee
Sun-Joo
SJ
Department of Obstetrics and Gynecology, Konkuk University Hospital, Konkuk University, Republic of Korea.
Kim
Woo Young
WY
Lee
Jeong-Won
JW
Kim
Hyoung Sun
HS
Choi
Yoon-La
YL
Ahn
Geung Hwan
GH
Lee
Je-Ho
JH
Kim
Byoung-Gie
BG
Bae
Duk-Soo
DS
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D002584:Cervix Uteri / Q000473:pathology / Q000601:surgery; D003080:Cold Temperature; D019092:Conization; D004564:Electrocoagulation; D004598:Electrosurgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007390:International Agencies; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery*