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Is radical hysterectomy necessary in early cervical cancer?

Abstract：

AIMS:To estimate the prevalence of tumor spread to the parametrium, vagina and uterine corpus in radical hysterectomy specimens and define a subgroup of patients with low-risk of extracervical involvement, who may benefit from less radical surgery. METHODS:We retrospectively reviewed 96 patients with stage IA1-IIA cervical cancer who had undergone radical hysterectomy and pelvic lymphadenectomy. RESULTS:Tumor spread beyond the uterine cervix was evident in 45 (47%) patients. Thirteen (13%) of the 96 patients had parametrial tumor spread, 12 (13%) had vaginal tumor extension, and 23 (24%) had uterine corpus involvement. Tumor size >2 cm, stromal invasion to a depth of ≥8 mm, and lymph vascular space invasion (LVSI) were significantly associated with extracervical invasion. Twenty-five patients had stromal invasion of <8 mm and no LVSI, of which only 1 (4%) had extracervical involvement. On the contrary, extracervical involvement was evident in 44 patients (63%) among those who had stromal invasion of ≥8 mm and/or LVSI (p < 0.001). Among women with LVSI, extracervical tumor spread was seen with any tumor size and any depth of stromal invasion. All patients with stromal invasion to a depth of >15 mm had extracervical invasion. CONCLUSION:Patients with tumor size <2 cm, depth of invasion of <8 mm and no LVSI could be considered for less radical surgery.

journal_name

Gynecol Obstet Invest

journal_title

Gynecologic and obstetric investigation

authors

Meirovitz M,Sade S,Dreiher J,Shaco-Levy R

doi

10.1159/000353899

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

158-62

issue

3

eissn

0378-7346

issn

1423-002X

pii

000353899

journal_volume

76

pub_type

杂志文章

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