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Korean Journal of Obstetrics & Gynecology 2005;48(11):2578-2585.
Published online November 1, 2005.
Conization by combination of loop electrosurgical excision procedure (LEEP) and cold coagulation for the stage Ia1 squamous cell carcinoma of the uterine cervix.
Kyung Lan Jung, Jeong Won Lee, Hea Yeon Lee, Yoon La Choi, Geung Hwan Ahn, Je Ho Lee, Byoung Gie Kim, Duk Soo Bae
1Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. bgkim@smc.samsung.co.kr
2Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Abstract
OBJECTIVE
This study was performed to evaluate the results of conization by loop electrosurgical excision procedure (LEEP) and cold coagulation as a definitive treatment in the patients with FIGO stage Ia1 squamous cell carcinoma of the cervix. METHODS: One hundred eighty-seven patients were diagnosed as stage Ia1 cervical squamous cell carcinomas from 1995 to 2004 by conization with LEEP and cold coagulation. Fifty-nine patients who wanted to preserve fertility and/or refused further surgical treatment were followed-up without further treatment. Eleven patients of the 59 had involved ectocervical resection margins. All patients were followed-up with cervicovaginal smear and colposcopic examination at a regular interval. Disease recurrence was defined as a histologic diagnosis of dysplasia or more. RESULTS: The median follow-up period was 69.0 months (range 8 to 103). All 59 patients had no lymphvascular space invasion (LVSI). In four patients, the ectocervical margins were involved by dysplasia, in seven patients, by carcinoma in-situ. There were no specific differences in ages, depth of stromal invasion and HPV status between the groups with and without involved margins. All 59 patients did not recur during follow-up period. CONCLUSION: Conization with LEEP and cold coagulation was feasible and could be used as a definitive therapy for the patients with stage Ia1 cervical squamous cell carcinoma. This study suggests that conization might play a role in a patient with positive margins (dysplasia or CIS) when LVSI is not demonstrated.
Key Words: Stage Ia1, Conization, LEEP, Cold coagulation, Resection margin


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