Clinical outcome of stage Ia1 squamous cell carcinoma of the uterine cervix and pathological findings of initial conization
Article first published online: 25 JUL 2011
© 2011 The Authors. Journal of Obstetrics and Gynaecology Research © 2011 Japan Society of Obstetrics and Gynecology
Journal of Obstetrics and Gynaecology Research
Volume 37, Issue 11, pages 1645–1649, November 2011
How to Cite
Yoshinaga, M., Hamada, T., Orita, Y., Yoshitomi (Shintomo), N., Matsuo, T., Tsuji, T., Tabata, K. and Douchi, T. (2011), Clinical outcome of stage Ia1 squamous cell carcinoma of the uterine cervix and pathological findings of initial conization. Journal of Obstetrics and Gynaecology Research, 37: 1645–1649. doi: 10.1111/j.1447-0756.2011.01590.x
- Issue published online: 27 OCT 2011
- Article first published online: 25 JUL 2011
- Received: September 5 2010.; Accepted: December 28 2010.
- clinical outcome;
- conization finding;
- International Federation of Gynecology and Obstetrics stage Ia1;
- squamous cell carcinoma;
- uterine cervix
Aim: The present study investigated the clinical outcome of stage Ia1 squamous cell carcinoma (SCC) of the uterine cervix at a single institute.
Materials and Methods: Subjects were 84 patients with cervical SCC, International Federation of Gynecology and Obstetrics stage Ia1 diagnosed according to conization findings between January 2000 and June 2009. Correlations between clinical outcome and pathological findings on initial conization were investigated.
Results: Of 65 hysterectomy (without pelvic lymphadenectomy) patients, two (3.1%) showed metastasis to the vaginal wall, and two (3.1%) to the pelvic lymph nodes. Five patients (6.0%) showed lymphovascular invasion, and three (3.6%) showed confluent patterns of stromal invasion (confluent invasion) on initial conization findings. All of these five patients were included in the hysterectomy group. Of 19 patients with conization alone, two showed vaginal metastasis. Of four patients with vaginal metastasis, two showed lymphovascular invasion and one showed confluent invasion despite negative conization margin. In patients with nodal metastasis, stromal invasion of 3.0 mm and 2.8 mm, and horizontal spread of 6.8 mm and 6.9 mm were observed on conization, respectively. All patients are currently alive due to adequate therapy including chemo-radiation for six patients with recurrent disease.
Conclusions: In patients showing stromal invasion of nearly 3.0 mm and horizontal spread of nearly 7.0 mm in stage Ia1 cervical SCC, pelvic lymphadenectomy may be considered. Even for patients showing a negative conization margin, careful follow up is necessary, because vaginal metastasis sometimes occurs.