Stage IA1 Squamous Cervical Carcinoma: A Report Of 47 Cases

Objective: This study aims at finding a appropriate strategy of diagnosis and treatment of stage IAl squamous cervical carcinoma.Methods: 47 cases of FIGO stage IAl cervical squamous carcinoma were treated in Women's Hospital School of Medicine Zhejing University during Jan 2000 and Dec 2004. Their clinical and pathological data were reviewed retrospectively.Results: The positive rate of cytological examination of these patients was 66.7%, while the positive rate of biopsy was 93.5%. 12 cases received hysterectomy without loop electrosurgical excision procedure(LEEP), in which, 6 cases received radical hysterectomy and pelvic lymphadenectomy. The other 35 cases received LEEP and ECC. In these 35 patients who had LEEP, 20(57.1%) were free margin, 15(42.9%) were involved margin, and no one had positive ECC. In the 20 cases whose margin was free, 5 preserved their fertility, the other 15 cases received hysterectomy: 14 extrafacial hysterectomy and 1 radical hysterectomy and pelvic lymphadenectomy. In the other 15 cases whose margin was involved, all had hysterectomy: 3 extrafacialhysterectomy and 12 radical hysterectomy and pelvic Iymphadenectomy. The residual rate of focus was 20.0% in free margin group and 53.3% in involved group according to the pathology of subsequent surgery, which had no statistic difference(P=0.058). In the 19 specimens which received radical hysterectomy and Iymphadenectomy, no positive lymph node or parametric infiltration was found. All of these 47 cases had follow-up and were contacted by telephone. No one was relapse or died from cervical carcinoma. In the 5 cases who preserved their fertility, 2 cases were still having contraception, and the other 3 had already been pregnant.Conclusions: LEEP is one of the appropriate methods to diagnose FIGO stage IA1 cervical squamous carcinoma, extrafacial hysterectomy is adequate to treat FIGO stage IA1 cervical squamous carcinoma.