The clinical study of microinvasive cervical cancer according to treatment modalities

Abstract

Objectives: The proportion of microinvasive disease in uterine cervical carcinoma have been increased. The aim of this study was to suggest proper management of microinvasive cervical carcinoma by analyzing clinocopathologic features, complications, recurrence and survival according to surgical management. Materials & Methods : From July 1, 1980 to September 30, 2001, at the Department of Obstetrics and Gynecology Hanyang University Hospital, we have reviewed 83 cases of stage la cervical cancer. And we devided 82 cases treated surgically into two groups: one was conservative treatment group had treated by therapeutic conization, type I hysterectomy or total vaginal hysterectomy, the other was radical treatment group had treated by type II hysterectomy or type III hysterectomy with pelvic lymph node dissection. We compared complication rate, recurrence rate, survival rate between two groups. The obtained data were analysing by chi square test. Results : The mean age at the time of diagnosis was 45.310.7 years old, The 83 cases consist of 78 cases of stage Ia1 and 5 cases of stage 1a2. The non-radical treatment group was 61 cases, which consists of 59 cases of type I hysterectomy or total vaginal hysterectomy and 2 cases of therapeutic conization. The radical treatment group was 21 cases, which consists of 10 cases of type II hysterectomy and 11 cases of hype III hysterectomy. There was no lymph node metastasis. One case was managed by radiotherapy due to its medical problem. There were no statistical differences between two groups for mean age(p=0.574), mean follow up period(p=0.787), depth of invasion(p=0.101), and lymphvascular invasion(p=0.755). The recurrence rate was 1.6 % and 4.8 %, respectively. The operative complication rate was 6.6 % and 81.7 %, respectively(p=0.424). There was statistical difference between two groups for operative complication rate(p=0.000). Conclusions: The study shows that the prognosis of microinvasive cervical cancer is relatively good and conservative treatment or less radical therapeutic approach may be sufficient. But further prospective study based on larger numbers will be necessary.