Analysis of outcomes of microinvasive adenocarcinoma of the uterine cervix by treatment type.
OBJECTIVE
To estimate the risk of metastatic disease in microinvasive adenocarcinoma of the cervix in a large cohort.


METHODS
Thirty-six cases were identified from the Mayo Clinic health information database, and 30 cases were identified using the University of Southern California gynecologic oncology patient database. Histopathology was reviewed by a single pathologist at each institution to confirm histologic subtype and grade of tumor, depth of invasion, linear extent of the tumor, the presence or absence of lymphovascular space invasion, margin status, parametrial involvement, and the presence of nodal metastasis.


RESULTS
Fifty-two patients had stage IA1 cancers and 14 had stage IA2 cancers. Therapy ranged from cold knife conization to radical hysterectomy with lymphadenectomy. No parametrial involvement was noted in any of the patients who underwent parametrial resection. One patient with stage IA1 cancer had micrometastasis to a pelvic lymph node. No recurrences were noted with an average follow-up of 80 months.


CONCLUSIONS
The management of microinvasive adenocarcinoma remains controversial, and radical therapy is applied more frequently to microinvasive adenocarcinoma than microinvasive squamous cell carcinoma of the cervix. The risk of extracervical disease is low and the risk of recurrence is not affected by the radicality of resection. Our data suggest that microinvasive adenocarcinoma is amenable to treatment with nonradical surgery.


METHODS
III.
Reynolds
Evelyn A
EA
Department of Obstetrics and Gynecology, Laboratory Medicine and Pathology, and Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA. ereynolds@kumc.edu
Tierney
Katherine
K
Keeney
Gary L
GL
Felix
Juan C
JC
Weaver
Amy L
AL
Roman
Lynda D
LD
Cliby
William A
WA
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D019092:Conization; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D055815:Young Adult