Ali Ayhan1, Eralp Başer1, Polat Dursun1, Asuman Nihan Haberal2. 1. Department of Obstetrics and Gynaecology, Division of Gynaecologic Oncology, Başkent University School of Medicine, Ankara, Turkey. 2. Department of Pathology, Başkent University School of Medicine, Ankara, Turkey.
Abstract
OBJECTIVE: To demonstrate the histopathological basis of individually tailored less radical surgery concept in patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB cervical cancer. MATERIAL AND METHODS: The study was performed in the gynaecologic oncology department of Başkent School of Medicine Hospital, Ankara, Turkey between January 1(st) 2008 and January 1(st) 2009. Cardinal and uterosacral ligaments were serially sectioned in an alternative approach, and were examined by a senior gynaecologic pathologist. Clinical and pathological features and findings in sections of uterine ligaments were recorded. Study data were analysed using the SPSS 17.0 program. RESULTS: Thirty-two out of 38 cases had squamous cell carcinoma (SCC) (84.2 %), and six had non-squamous cell tumours (15.8%). Four cases had microscopic (10.5 %) and one case had macroscopic (2.6 %) tumour extension in cardinal ligaments. Mean tumour-free cardinal ligament length was 16.8±7.39 mm. Presence of tumour invasion in cardinal ligaments correlated significantly with pelvic lymph node metastasis (p=0.02). No isolated tumour deposits were found in any of the cases in serial sections of the cardinal or uterosacral ligaments. CONCLUSION: This research was designed as a preliminary study. Future studies are needed to determine the optimal resection margins of the uterine ligaments in surgically treated stage IB cervical cancer. With continuing research and the development of newer surgical techniques, patients' quality of life will be optimised accordingly.
OBJECTIVE: To demonstrate the histopathological basis of individually tailored less radical surgery concept in patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB cervical cancer. MATERIAL AND METHODS: The study was performed in the gynaecologic oncology department of Başkent School of Medicine Hospital, Ankara, Turkey between January 1(st) 2008 and January 1(st) 2009. Cardinal and uterosacral ligaments were serially sectioned in an alternative approach, and were examined by a senior gynaecologic pathologist. Clinical and pathological features and findings in sections of uterine ligaments were recorded. Study data were analysed using the SPSS 17.0 program. RESULTS: Thirty-two out of 38 cases had squamous cell carcinoma (SCC) (84.2 %), and six had non-squamous cell tumours (15.8%). Four cases had microscopic (10.5 %) and one case had macroscopic (2.6 %) tumour extension in cardinal ligaments. Mean tumour-free cardinal ligament length was 16.8±7.39 mm. Presence of tumour invasion in cardinal ligaments correlated significantly with pelvic lymph node metastasis (p=0.02). No isolated tumour deposits were found in any of the cases in serial sections of the cardinal or uterosacral ligaments. CONCLUSION: This research was designed as a preliminary study. Future studies are needed to determine the optimal resection margins of the uterine ligaments in surgically treated stage IB cervical cancer. With continuing research and the development of newer surgical techniques, patients' quality of life will be optimised accordingly.
Authors: D Cibula; N R Abu-Rustum; P Benedetti-Panici; C Köhler; F Raspagliesi; D Querleu; C P Morrow Journal: Gynecol Oncol Date: 2011-05-17 Impact factor: 5.482
Authors: Mitchel S Hoffman; Vonetta Williams; Hamisu M Salihu; Sivaselvi Gunasekaran; Robyn A Sayer; Ardeshir Hakam; William S Roberts Journal: Am J Obstet Gynecol Date: 2008-06-13 Impact factor: 8.661