title: Evaluation of cervical conization as a definitive treatment for microinvasive cervical carcinoma and cervical intraepithelial neoplasia grade 3.
abstract: OBJECTIVE
  The aim of the study was to evaluate disease persistence after conization of CIN3 and microinvasive cervical carcinoma.
  
  
  METHODS
  Medical records from a total of 231 patients were reviewed. The prevalence of CIN3 and cervical carcinoma diagnosed by means of conization were analyzed. All conizations were performed under lumbar anesthesia using a laser technique.
  
  
  RESULTS
  Of the 231 patients, 25 had margin involvement with CIN3 or microinvasive carcinoma. Among these 25 patients, 10 underwent hysterectomy. Two of these 10 patients had CIN3 and eight had microinvasive carcinoma. Residual disease was observed in hysterectomy specimens from 9 of the 10 patients. Of the eight patients diagnosed with microinvasion from post-cone hysterectomy specimens, four had CIN3 and three had microinvasive carcinoma. The three patients with microinvasion were found to have a larger area of residual disease as compared with other patients with margin involvement.
  
  
  CONCLUSIONS
  Conization alone seems to be a reasonable treatment for patients with CIN1, 2, 3, and microinvasive carcinoma. For adenocarcinoma, in situ treatment with conization alone is possible but requires careful follow-up. Hysterectomy appears to be a safe treatment option for microinvasive adenocarcinoma, although follow-up by cytology is sometimes possible in cases with negative surgical margins.
authors.affiliation: Department of Obstetrics and Gynecology, Sapporo Medical University, South 1 West16 chuo-ku, Sapporo, Hokkaido 060-8556, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Takeda
authors.forename: Takahiro
authors.initials: T
authors.lastname: Suzuki
authors.forename: Miwa
authors.initials: M
authors.lastname: Suzuki
authors.forename: Motoki
authors.initials: M
authors.lastname: Matsuura
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Tanaka
authors.forename: Miho
authors.initials: M
authors.lastname: Fujii
authors.forename: Eiki
authors.initials: E
authors.lastname: Ito
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Saito
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery*; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery; D019092:Conization; D005260:Female; D006801:Humans; D007044:Hysterectomy; D053685:Laser Therapy; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D018365:Neoplasm, Residual; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery*; D055815:Young Adult