title: Surgical approach and long-term clinical outcome in women with microinvasive cervical cancer.
abstract: OBJECTIVE
  To assess the efficacy and safety of conservative surgical approach for microinvasive cervical cancer with regards to cone margins status and lymph vascular space invasion (LVSI).
  
  
  METHODS
  This was a multicentre retrospective cohort study of 153 women diagnosed with microinvasive cervical cancer over a 10 years period (1993-2003).
  
  
  RESULTS
  In conservatively-treated women (n=80), neither cancer mortality nor disease relapse after 184.5 ± 20.5 months of follow-up was detected. Residual disease in women who underwent secondary surgery was significantly related to positive margins on the primary cone excision (p=0.005) while no correlation with LVSI emerged.
  
  
  CONCLUSIONS
  Conization can represent the definitive treatment for stage IA1, if surgical margins are cancer-free, independently of LVSI. A conservative surgical approach could also be considered in women with IA2 cervical cancer when preservation of fertility is strongly requested. A close long-term surveillance should be scheduled for conservatively-treated women.
authors: Department of Gynecological Oncology, Centro di Riferimento Oncologico, Aviano, Italy.
authors: Francesco
authors: F
authors: Sopracordevole
authors: Department of Gynaecological, Obstetric and Pediatric Sciences, Section of Gynaecology, University of Modena and Reggio Emilia, Modena, Italy.
authors: Giuseppe
authors: G
authors: Chiossi
authors: Department of Obstetrics and Gynecology, Asti Community Hospital, Asti, Italy.
authors: Maggiorino
authors: M
authors: Barbero
authors: Department of Obstetrics and Gynecology, University of Genoa, Genoa, Italy.
authors: Paolo
authors: P
authors: Cristoforoni
authors: Department of Pathology, University of Turin, Turin, Italy.
authors: Bruno
authors: B
authors: Ghiringhello
authors: 2nd Clinic of Obstetrics and Gynaecology, University "La Sapienza", Rome, Italy.
authors: Antonio
authors: A
authors: Frega
authors: Department of Gynaecological, Obstetric and Pediatric Sciences, Section of Gynaecology, University of Modena and Reggio Emilia, Modena, Italy.
authors: Francesca
authors: F
authors: Tortolani
authors: Department of Gynaecological, Obstetric and Pediatric Sciences, Section of Gynaecology, University of Modena and Reggio Emilia, Modena, Italy.
authors: Fausto
authors: F
authors: Boselli
authors: Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy.
authors: Nicolò
authors: N
authors: Clemente
authors: Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Ancona, Italy ciavattini.a@libero.it.
authors: Andrea
authors: A
authors: Ciavattini
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: Conization; cone margins; lymph vascular space invasion; microinvasive cervical cancer