title: Multifocal FIGO Stage IA1 Squamous Carcinoma of the Cervix: Criteria for Identification, Staging, and its Good Clinical Outcome.
abstract: Multifocal squamous cervical carcinomas account for up to 25% of IA1 tumors identified on excisional biopsy, yet there are no uniformly accepted histopathologic criteria for defining and staging these lesions. Here, we use a strict case definition and meticulous specimen processing from colposcopist to pathologist to identify and follow-up 25 cases of multifocal IA1 cervical squamous carcinomas identified in excisional biopsies. We stage these tumors using the dimensions of the largest focus and a minimum of 2 mm between each foci to define multifocality. The cases are followed up for a median of 7 yr with no episodes of tumor recurrence or metastasis. We also show that the prevalence of residual preinvasive (20%) and invasive disease (5%) on repeat excision/surgery are comparable to data available for unifocal IA1 cases. Our study supports the hypothesis that multifocal lesions should be staged according to largest individual focus of invasion and we emphasize the importance of meticulous specimen handling to appropriately identify multifocal tumors. In addition, our analysis suggests that outcomes are comparable to unifocal lesions and supports the hypothesis that they may be managed in a similar manner.
authors: NHS Greater Glasgow and Clyde (E.D., S.D.) Department of Pathology (G.B., S.S., D.M.), Queen Elizabeth University Hospital Department of Gynaecological Oncology (S.S., K.B., R.L., N.S.), Princess Royal Maternity Hospital, Alexandra Parade, Glasgow, UK.
authors: Elizabeth
authors: E
authors: Day
authors: Siobhan
authors: S
authors: Duffy
authors: Gareth
authors: G
authors: Bryson
authors: Sheeba
authors: S
authors: Syed
authors: Smruta
authors: S
authors: Shanbhag
authors: Kevin
authors: K
authors: Burton
authors: Rhona
authors: R
authors: Lindsay
authors: Nadeem
authors: N
authors: Siddiqui
authors: David
authors: D
authors: Millan
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000145:classification* / Q000473:pathology / Q000601:surgery; D002584:Cervix Uteri / Q000473:pathology / Q000601:surgery; D003127:Colposcopy; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D011247:Pregnancy; D002583:Uterine Cervical Neoplasms / Q000145:classification* / Q000473:pathology / Q000601:surgery