| Clinical Analysis of 221 Cases of Microinvasive Carcinoma of the Cervix. |
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Joo Hyun Nam, Sung Hoon Kim, Jong Hyeok Kim, Yong Man Kim, Young Tak Kim, Jung Eun Mok |
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Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea. |
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| Abstract |
OBJECTIVE
To review and evaluate a series of patients who underwent surgical management due to microinvasive cervical cancer. MATERIALS and METHODS: Records of 221 patients with microinvasive cervical cancer treated in Asan Medical Center (AMC) from June 1989 to December 2000 were reviewed. Demographic profile, findings in preoperative work-up, treatment modality, histologic findings and post-treatment clinical course were evaluated. RESULTS: The age range at initial operation was 27 to 79 and the mean age was 44.5+/-11.4 (mean+/-SD) years. Patients were followed from 3 months to 11.7 years with median follow-up interval of 4.5 years. According to the pathologic report, 212 cases (95.9%) were diagnosed as squamous cell carcinoma and 9 cases (4.1%) as adenocarcinoma. The number of patients with FIGO stage Ia1 and Ia2 disease was 202 (91.4%) and 19 (8.6%), respectively. The cases with invasion of < or = 1 mm, > 1 mm but < or = 3 mm, and > 3 mm but < or = 5 mm were noted in 120 (54.3%), 82 (37.1%), and 19 (8.6%) patients, respectively. Pelvic lymph node dissection (PLND) was performed in 140 patients and the average number of lymph nodes examined per case was 21+/-7. None of the 140 patients had metastasis to pelvic lymph node. Lymphovascular space invasion was identified in 7 patients. Pelvic recurrence was developed in only one patient and none of the 221 patients has died from recurrent disease. CONCLUSION: This study shows that patients with microinvasive cervical cancer have no pelvic lymph node metastasis, rare recurrence, and very excellent prognosis, so, if indicated, conservative management or non-radical surgery excluding pelvic lymph node dissection could be tried. |
| Key Words:
microinvasive, cervix, cancer |
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