OBJECTIVE: To investigate the efficacy of different treatment modalities used in microinvasive adenocarcinoma (AC) of the uterine cervix (FIGO stage IA1 and IA2), and review the literature. METHODS: Medical and histopathological records of 38 patients treated for microinvasive AC of the cervix were studied retrospectively, and compared with the literature. RESULTS: Twenty-nine patients had stage IA1 and nine stage IA2 cancers. Treatment modalities ranged from radical hysterectomy with pelvic lymph node dissection (PLND) to conization only. Eighteen patients underwent a conization, including two patients with stage IA2 disease, of whom 11 had 18 pregnancies in total, resulting in 13 live births, two terminations and three spontaneous abortions. In two patients a hysterectomy was performed after pregnancy. No recurrences were noted during an average follow-up of 72 months. In the literature 1565 patients were reported. Of the 814 patients undergoing PLND, 12 had positive nodes. Lymphovascular space invasion (LVSI) was present in 25 patients, all without node involvement. None of the 356 described parametria were involved. Twenty-nine recurrences occurred. In total, 21 pregnancies with 16 live births occurred in those patients treated to preserve fertility. CONCLUSIONS: There is no uniformity in the treatment of microinvasive AC of the uterine cervix. For stage IA1 disease, conization seems to be safe and PLND is only recommended where LVSI is present. Although the number of reported cases is small, for stage IA2 disease, conization with PLND in case of LVSI seems advisable. More studies are desirable to define the optimal treatment for patients with microinvasive AC of the cervix, especially with regard to those patients with stage IA2 disease.
OBJECTIVE: To investigate the efficacy of different treatment modalities used in microinvasive adenocarcinoma (AC) of the uterine cervix (FIGO stage IA1 and IA2), and review the literature. METHODS: Medical and histopathological records of 38 patients treated for microinvasive AC of the cervix were studied retrospectively, and compared with the literature. RESULTS: Twenty-nine patients had stage IA1 and nine stage IA2 cancers. Treatment modalities ranged from radical hysterectomy with pelvic lymph node dissection (PLND) to conization only. Eighteen patients underwent a conization, including two patients with stage IA2 disease, of whom 11 had 18 pregnancies in total, resulting in 13 live births, two terminations and three spontaneous abortions. In two patients a hysterectomy was performed after pregnancy. No recurrences were noted during an average follow-up of 72 months. In the literature 1565 patients were reported. Of the 814 patients undergoing PLND, 12 had positive nodes. Lymphovascular space invasion (LVSI) was present in 25 patients, all without node involvement. None of the 356 described parametria were involved. Twenty-nine recurrences occurred. In total, 21 pregnancies with 16 live births occurred in those patients treated to preserve fertility. CONCLUSIONS: There is no uniformity in the treatment of microinvasive AC of the uterine cervix. For stage IA1 disease, conization seems to be safe and PLND is only recommended where LVSI is present. Although the number of reported cases is small, for stage IA2 disease, conization with PLND in case of LVSI seems advisable. More studies are desirable to define the optimal treatment for patients with microinvasive AC of the cervix, especially with regard to those patients with stage IA2 disease.
Authors: Andres A Roma; Toni-Ann Mistretta; Andrea Diaz De Vivar; Kay J Park; Isabel Alvarado-Cabrero; Golnar Rasty; Jose G Chanona-Vilchis; Yoshiki Mikami; Sung R Hong; Norihiro Teramoto; Rouba Ali-Fehmi; Denise Barbuto; Joanne K L Rutgers; Elvio G Silva Journal: Gynecol Oncol Date: 2016-04 Impact factor: 5.482
Authors: Ramez N Eskander; Leslie M Randall; Michael L Berman; Krishnansu S Tewari; Philip J Disaia; Robert E Bristow Journal: Am J Obstet Gynecol Date: 2011-03-16 Impact factor: 8.661
Authors: Joanne K L Rutgers; Andres A Roma; Kay J Park; Richard J Zaino; Abbey Johnson; Isabel Alvarado; Dean Daya; Golnar Rasty; Teri A Longacre; Brigitte M Ronnett; Elvio G Silva Journal: Mod Pathol Date: 2016-06-03 Impact factor: 7.842
Authors: Francesco Sopracordevole; Diego Rossi; Jacopo Di Giuseppe; Marta Angelini; Pierino Boschian-Bailo; Monica Buttignol; Andrea Ciavattini Journal: Case Rep Obstet Gynecol Date: 2014-03-16