TY - JOUR
T1 - Conservative surgical treatment in cervical cancer with 3 to 5 mm stromal invasion in the absence of confluent invasion and lymph-vascular space involvement
AU - Yaegashi, Nobuo
AU - Sato, Shinji
AU - Inoue, Yoshiki
AU - Noda, Kiichiro
AU - Yajima, Akira
PY - 1994/9
Y1 - 1994/9
N2 - We have previously reported that simple hysterectomy is adequate therapy for microinvasive carcinoma of the cervix with less than 3 mm stromal invasion (Yajima, A., et al, Am. J. Obstet. Gynecol. 135, 685-688, 1979). However, whether it is possible to effectively treat patients with deeper stromal invasion remained in question. A policy for surgical treatment in patients with 3 to 5 mm invasion has not been standardized. Although radical hysterectomy is usually performed, some authors insist that patients with 3 to 5 mm invasion can be safely treated conservatively. Patients treated with conservative surgery should he carefully assessed because cases with confluent invasion or lymph-vascular space invasion have a greater potential for lymph node metastasis and carry a worse prognosis. Conservative treatment in this study was limited to patients with microinvasive carcinoma with 3 to 5 mm invasion, stage IB occult patients (classified by the FIGO 1973 staging system). The patients were preoporatively diagnosed with either carcinoma in situ or microinvasive carcinoma, and treated by conservative surgery (conization, simple hysterectomy, or extended hysterectomy). Twenty-two patients with 3 to 5 mm invasion but without additional risk factors, i.e., confluent invasion or lymph-vascular space involvement, were followed without postoperative radiation therapy. All patients survived except one (who died of an intercurrent disease) and there were no signs of recurrence or serious surgical complications. The present study with stage IB occ subjects suggests that conservative therapy rather than radical hysterectomy can be used in a very carefully selected subset of patients, i.e., in cases with 3 to 5 mm microinvasive carcinoma without additional risk factors, such as confluent invasion and lymph-vascular space invasion.
AB - We have previously reported that simple hysterectomy is adequate therapy for microinvasive carcinoma of the cervix with less than 3 mm stromal invasion (Yajima, A., et al, Am. J. Obstet. Gynecol. 135, 685-688, 1979). However, whether it is possible to effectively treat patients with deeper stromal invasion remained in question. A policy for surgical treatment in patients with 3 to 5 mm invasion has not been standardized. Although radical hysterectomy is usually performed, some authors insist that patients with 3 to 5 mm invasion can be safely treated conservatively. Patients treated with conservative surgery should he carefully assessed because cases with confluent invasion or lymph-vascular space invasion have a greater potential for lymph node metastasis and carry a worse prognosis. Conservative treatment in this study was limited to patients with microinvasive carcinoma with 3 to 5 mm invasion, stage IB occult patients (classified by the FIGO 1973 staging system). The patients were preoporatively diagnosed with either carcinoma in situ or microinvasive carcinoma, and treated by conservative surgery (conization, simple hysterectomy, or extended hysterectomy). Twenty-two patients with 3 to 5 mm invasion but without additional risk factors, i.e., confluent invasion or lymph-vascular space involvement, were followed without postoperative radiation therapy. All patients survived except one (who died of an intercurrent disease) and there were no signs of recurrence or serious surgical complications. The present study with stage IB occ subjects suggests that conservative therapy rather than radical hysterectomy can be used in a very carefully selected subset of patients, i.e., in cases with 3 to 5 mm microinvasive carcinoma without additional risk factors, such as confluent invasion and lymph-vascular space invasion.
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U2 - 10.1006/gyno.1994.1219
DO - 10.1006/gyno.1994.1219
M3 - Article
C2 - 8088610
AN - SCOPUS:0028128345
VL - 54
SP - 333
EP - 337
JO - Gynecologic Oncology
JF - Gynecologic Oncology
SN - 0090-8258
IS - 3
ER -