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Korean Journal of Obstetrics & Gynecology 2001;44(10):1870-1876.
Published online October 1, 2001.
Clinical Analysis of 221 Cases of Microinvasive Carcinoma of the Cervix.
Joo Hyun Nam, Sung Hoon Kim, Jong Hyeok Kim, Yong Man Kim, Young Tak Kim, Jung Eun Mok
Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
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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