Hopkins M P, Morley G W
Department of Obstetrics and Gynecology, University of Michigan Medical Center, Ann Arbor.
J Reprod Med. 1994 Sep;39(9):671-3.
The International Federation of Gynecologists and Obstetricians (FIGO) definition of microinvasive carcinoma of the cervix changed recently. We clinically reviewed our treatment of superficially invasive cancer of the cervix in light of those changes. The review covered all patients treated at the University of Michigan from 1970 to 1985 who had stage I squamous cell carcinoma of the cervix, with the Society of Gynecologic Oncologists (SGO) and new FIGO criteria for microinvasion used. Using SGO criteria, 43 patients were treated as follows: total abdominal hysterectomy (32), total vaginal hysterectomy (7), radical hysterectomy (2) and cone biopsy (2). One patient, who had multifocal disease with a maximum depth of 1.5 mm, developed a recurrence and died of the disease. A review of 345 patients considered to have stage IB disease under SGO criteria showed 30 patients who were reclassified as having stage IA2. All these patients were treated with radical surgery and survived, and all had negative lymph nodes. Radical surgery for patients with more than microinvasion according to SGO criteria provides excellent survival rates. Radical therapy may also be indicated for multifocal lesions.
国际妇产科联盟(FIGO)对子宫颈微浸润癌的定义最近发生了变化。我们根据这些变化对子宫颈浅表浸润癌的治疗进行了临床回顾。该回顾涵盖了1970年至1985年在密歇根大学接受治疗的所有子宫颈I期鳞状细胞癌患者,并采用了妇科肿瘤学家协会(SGO)和FIGO新的微浸润标准。根据SGO标准,43例患者接受了如下治疗:经腹全子宫切除术(32例)、经阴道全子宫切除术(7例)、根治性子宫切除术(2例)和锥形活检(2例)。1例患有多灶性疾病、最大深度为1.5 mm的患者出现复发并死于该疾病。对345例根据SGO标准被认为患有IB期疾病的患者进行回顾发现,有30例患者被重新分类为患有IA2期疾病。所有这些患者均接受了根治性手术并存活下来,且所有患者的淋巴结均为阴性。根据SGO标准,对微浸润以上的患者进行根治性手术可提供优异的生存率。对于多灶性病变也可能需要进行根治性治疗。