Department of Gynecology and Obstetrics, University Medical Centre Ljubljana, Slovenia.
Gynecol Oncol. 2012 Jan;124(1):68-71. doi: 10.1016/j.ygyno.2011.09.032. Epub 2011 Oct 20.
The objective of this analysis was to present the clinical outcome of the patients with FIGO stage IA2 squamous cell cervical cancer treated at the Department of Obstetrics and Gynecology between 1973 and 2009, and to clarify the discrepancies in clinical guidelines regarding the radicality of treatment applied in patients with stage IA2 squamous cell cervical cancer.
In our study we enrolled 89 women, diagnosed with FIGO stage IA2 squamous cell microinvasive carcinoma (MIC) in the period 1973-2009. The analysis involved the following parameters women's age at operation, type of operation, cell type, mitotic activity, invasive growth pattern, host defense reaction, lymph-vascular space invasion and patient's survival. Additionally, using the Rainer's scoring system, the prognostic score for each MIC was calculated.
The mean women's age at operation was 41.48 ± 10.67 years. The mean depth of invasion was 3.09 ± 1.13 mm, and the mean area of carcinoma 4.05 ± 2.40 mm(2). In 66 (74.2%) women the suggested treatment was conization, according to the Rainer's scoring system and individualization of treatment based on decision of the tumor board. Three of the 89 patients diagnosed with MIC stage IA2 died; only in one patient the cause of death was cervical carcinoma. At the end of the observed period the survival rate was 98.0%.
We may conclude that conservative management of stage IA2 MIC is safe when exact evaluation of tumor extension and surgical margins of the cone are considered, and results in very low risk of recurrence, lymph node disease, and death caused by cancer. We believe that our experience will contribute to the achievement of the international consensus concerning the treatment of IA2 MIC.
本分析旨在介绍妇产科于 1973 年至 2009 年间治疗的 FIGO 分期 IA2 鳞状细胞宫颈癌患者的临床结果，并阐明临床指南在 IA2 期宫颈癌患者的治疗方法上的差异。
在我们的研究中，我们纳入了 89 名被诊断为 1973-2009 年FIGO 分期 IA2 鳞状细胞微浸润癌（MIC）的女性。分析包括以下参数：手术时的年龄、手术类型、细胞类型、有丝分裂活性、侵袭性生长模式、宿主防御反应、淋巴血管空间侵犯以及患者的生存情况。此外，我们使用 Rainer 评分系统计算了每位 MIC 的预后评分。
手术时女性的平均年龄为 41.48 ± 10.67 岁。平均浸润深度为 3.09 ± 1.13mm，平均癌面积为 4.05 ± 2.40mm²。根据 Rainer 评分系统和肿瘤委员会的个体化治疗决策，建议 66 名（74.2%）患者进行锥形切除术。89 名被诊断为 MIC 分期 IA2 的患者中有 3 人死亡；只有 1 例患者的死亡原因为宫颈癌。在观察期结束时，生存率为 98.0%。
当考虑肿瘤扩展和锥形切除的手术边缘时，我们可以得出结论，IA2 MIC 的保守治疗是安全的，并且复发、淋巴结疾病和癌症导致的死亡风险非常低。我们相信我们的经验将有助于达成关于 IA2 MIC 治疗的国际共识。
