OBJECTIVE: To estimate the risk of metastatic disease in microinvasive adenocarcinoma of the cervix in a large cohort. METHODS: Thirty-six cases were identified from the Mayo Clinic health information database, and 30 cases were identified using the University of Southern California gynecologic oncology patient database. Histopathology was reviewed by a single pathologist at each institution to confirm histologic subtype and grade of tumor, depth of invasion, linear extent of the tumor, the presence or absence of lymphovascular space invasion, margin status, parametrial involvement, and the presence of nodal metastasis. RESULTS: Fifty-two patients had stage IA1 cancers and 14 had stage IA2 cancers. Therapy ranged from cold knife conization to radical hysterectomy with lymphadenectomy. No parametrial involvement was noted in any of the patients who underwent parametrial resection. One patient with stage IA1 cancer had micrometastasis to a pelvic lymph node. No recurrences were noted with an average follow-up of 80 months. CONCLUSION: The management of microinvasive adenocarcinoma remains controversial, and radical therapy is applied more frequently to microinvasive adenocarcinoma than microinvasive squamous cell carcinoma of the cervix. The risk of extracervical disease is low and the risk of recurrence is not affected by the radicality of resection. Our data suggest that microinvasive adenocarcinoma is amenable to treatment with nonradical surgery. LEVEL OF EVIDENCE: III.
OBJECTIVE: To estimate the risk of metastatic disease in microinvasive adenocarcinoma of the cervix in a large cohort. METHODS: Thirty-six cases were identified from the Mayo Clinic health information database, and 30 cases were identified using the University of Southern California gynecologic oncology patient database. Histopathology was reviewed by a single pathologist at each institution to confirm histologic subtype and grade of tumor, depth of invasion, linear extent of the tumor, the presence or absence of lymphovascular space invasion, margin status, parametrial involvement, and the presence of nodal metastasis. RESULTS: Fifty-two patients had stage IA1 cancers and 14 had stage IA2 cancers. Therapy ranged from cold knife conization to radical hysterectomy with lymphadenectomy. No parametrial involvement was noted in any of the patients who underwent parametrial resection. One patient with stage IA1cancer had micrometastasis to a pelvic lymph node. No recurrences were noted with an average follow-up of 80 months. CONCLUSION: The management of microinvasive adenocarcinoma remains controversial, and radical therapy is applied more frequently to microinvasive adenocarcinoma than microinvasive squamous cell carcinoma of the cervix. The risk of extracervical disease is low and the risk of recurrence is not affected by the radicality of resection. Our data suggest that microinvasive adenocarcinoma is amenable to treatment with nonradical surgery. LEVEL OF EVIDENCE: III.
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: Carlos Parra-Herran; Monica Taljaard; Bojana Djordjevic; M Carolina Reyes; Lauren Schwartz; John K Schoolmeester; Ricardo R Lastra; Charles M Quick; Anna Laury; Golnar Rasty; Marisa R Nucci; Brooke E Howitt Journal: Mod Pathol Date: 2016-05-13 Impact factor: 7.842
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: Ester P Olthof; Maaike A van der Aa; Judit A Adam; Lukas J A Stalpers; Hans H B Wenzel; Jacobus van der Velden; Constantijne H Mom Journal: Int J Clin Oncol Date: 2021-07-09 Impact factor: 3.402