Assessment of the Revised International Federation of Gynecology and Obstetrics Staging for Early Invasive Squamous Cervical Cancer

Treatment and outcome of stage Ia1 squamous cell carcinoma of the uterine cervix

“…A low risk of lymph node metastasis, recurrence and death has been found in microinvasive cervical carcinoma [6,10]. In the present study, no positive lymph nodes were found among 52 patients with stage IA1 disease.…”

“…Historically, stage IA1 disease has been managed by various procedures, including radical ones [6]. The actual incidence of parametrial invasion [10] and lymph node involvement is negligible, and patients can be adequately treated by simple hysterectomy without lymphadenectomy. As a surgical procedure in patients with stage IA1 cervical SCC, conization is still recommended.…”

Microinvasive Carcinoma of the Cervix

“…Tumor volume is difficult to measure, and some have used horizontal length as an alternative. In general, tumor volume and tumor length are proportional to the depth of invasion, 39 such that tumors that are more deeply invasive also exhibit greater horizontal growth. The frequency with which residual carcinoma is found in postconization hysterectomy specimens increases from 2% for cancers with less than 4 mm of horizontal spread to 27% for 4-to 8-mm horizontal tumor spread and 35% when the horizontal spread is greater than 8 mm.…”

Conservative surgery for early stage cervical carcinoma

“…The risk of lymph node involvement and recurrence is related to tumour size and stromal invasion [12]. Horizontal dimensions of greater than 7 mm increase the chance of lymph node involvement (see Table 3).…”

“…The incidence of lymph node involvement is low in Stages 1a1 and 1a2 disease but critical to establish since it can impact on survival. The pathological significance of micro-metastasis requires more work to elucidate whether it Table 3 Relationship between horizontal width of tumour and positive lymph nodes and recurrence for superficial cervical cancer [12] Horizontal width of lesion could be related to those who develop recurrence despite having apparently good prognostic features [16]. Such information may only be available in those patients for treatment planning who have had a pelvic/para-aortic lymphadenectomy prior to definitive surgery.…”