title: Treatment and outcome of stage Ia1 squamous cell carcinoma of the uterine cervix.
abstract: OBJECTIVE
  To evaluate the treatment and clinical outcome of patients with FIGO stage IA1 cervical squamous cell carcinoma (SCC).
  
  
  METHODS
  Medical records, including 5-year follow-up, were reviewed for 276 patients with stage IA1 SCC.
  
  
  RESULTS
  As definitive surgery, 152 (55.1%), 72 (26.1%), 40 (14.5%), and 12 (4.3%) patients underwent conization, hysterectomy, hysterectomy with pelvic lymphadenectomy (PL), and radical hysterectomy with PL, respectively. Among these groups, the 5-year recurrence-free rate was 94.1%, 98.6%, 95%, and 100%, respectively, and the survival rate was 98.7%, 98.6%, 100%, and 100%, respectively. Recurrent disease was identified among 12 (4.3%) patients, and was related to the depth of invasion (P<0.001). Eleven (4.0%) of 276 patients were found to have lymph vascular space invasion (LVSI). There were no positive lymph nodes among 52 patients who underwent PL, including those with LVSI. Conization was followed by hysterectomy in 49 patients. In these patients, residual intraepithelial neoplasia was found in 18 women, 3 of whom had no involved margins on previous conization. In the group of patients treated by conization, recurrence correlated with the status of the endocervical and lateral cone margin (P<0.001).
  
  
  CONCLUSIONS
  As a conservative approach, conization is an effective and reasonable treatment option for stage IA1 SCC, especially in actively reproductive women.
authors.affiliation: Department of Obstetrics and Gynecology, Clinical Hospital Centre, School of Medicine, University of Rijeka, Rijeka, Croatia.
authors.forename: Herman
authors.initials: H
authors.lastname: Haller
authors.forename: Maja
authors.initials: M
authors.lastname: Krašević
authors.forename: Ozren
authors.initials: O
authors.lastname: Mamula
authors.forename: Alemka
authors.initials: A
authors.lastname: Brnčić-Fischer
authors.forename: Senija
authors.initials: S
authors.lastname: Eminović
authors.forename: Miljenko
authors.initials: M
authors.lastname: Manestar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D019092:Conization / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D008197:Lymph Node Excision / Q000379:methods; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology*