Early Adenocarcinoma of the Uterine Cervix

Kaku, Tsunehisa; Kamura, Toshiharu; Sakai, Kunihiro; Amada, Satoshi; Kobayashi, Hiroaki; Shigematsu, Toshiyuki; Saito, Toshiaki; Nakano, Hitoo

doi:10.1006/gyno.1997.4652

Cited by 54 publications

(32 citation statements)

References 8 publications

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“…Although carcinomas with >3-mm invasion are at increased risk of presenting with positive lymph nodes, most patients undergoing lymphadenectomy do not demonstrate metastasis. Conversely, superficial tumors can occasionally present with relatively advanced disease (3)(4)(5)(6)(7)(8)(9)(10). Although lymph node dissection constitutes the usual treatment, unfortunately it is not performed without risk of significant morbidity for patients, many of whom are at a young age (11,12).…”

mentioning

confidence: 99%

Invasive Endocervical Adenocarcinoma

Vivar¹,

Roma²,

Park³

et al. 2013

International Journal of Gynecological Pathology

114

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The management of endocervical adenocarcinoma is largely based on tumor size and depth of invasion (DOI); however, DOI is difficult to measure accurately. The surgical treatment includes resection of regional lymph nodes, even though most lymph nodes are negative and lymphadenectomies can cause significant morbidity. We have investigated alternative parameters to better identify patients at risk of node metastases. Cases of invasive endocervical adenocarcinoma from 12 institutions were reviewed, and clinical/pathologic features assessed: patients' age, tumor size, DOI, differentiation, lymph-vascular invasion, lymph node metastases, recurrences, and stage. Cases were classified according to a new pattern-based system into Pattern A (well-demarcated glands), B (early destructive stromal invasion arising from well-demarcated glands), and C (diffuse destructive invasion). In total, 352 cases (FIGO Stages I-IV) were identified. Patients' age ranged from 20 to 83 years (mean 45), DOI ranged from 0.2 to 27 mm (mean 6.73), and lymph-vascular invasion was present in 141 cases. Forty-nine (13.9%) demonstrated lymph node metastases. Using this new system, 73 patients (20.7%) with Pattern A tumors (all Stage I) were identified. None had lymph node metastases and/or recurrences. Ninety patients (25.6%) had Pattern B tumors, of which 4 (4.4%) had positive nodes; whereas 189 (53.7%) had Pattern C tumors, of which 45 (23.8%) had metastatic nodes. The proposed classification system can spare 20.7% of patients (Pattern A) of unnecessary lymphadenectomy. Patients with Pattern B rarely present with positive nodes. An aggressive approach is justified in patients with Pattern C. This classification system is simple, easy to apply, and clinically significant.

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mentioning

confidence: 99%

Invasive Endocervical Adenocarcinoma

Vivar¹,

Roma²,

Park³

et al. 2013

International Journal of Gynecological Pathology

114

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“…Teshima et al 7 reported that one patient (depth 3 mm, width unknown) developed recurrence among 22 patients. Kaku et al 8 reported no nodal disease and two cases of recurrence among 30 patients. One patient had a tumour with a depth of 3.9 mm and a width of 4.9 mm, and the other had a tumour with a depth of 4.1 mm and a width of 14.1 mm.…”

Section: Discussionmentioning

confidence: 96%

“…Thus, we assume that the borderline tumour volume to define microinvasive cervical adenocarcinoma should be set at nearly half of that in Kasper et al's report 11 . Indeed, this tumour volume concept was not recommended by Kaku et al 8 , who reassessed it in 30 cervical adenocarcinoma patients with a depth of tumour invasion of 5 mm or less. The tumour volume in their two recurrent cases was 1222 and 136.9 mm 3 , respectively.…”

Section: Discussionmentioning

confidence: 99%

“…First, one may wonder whether other prognostic parameters such as tumour grade or the presence of capillary space involvement are relevant. The FIGO staging system does not take these factors into account 1 , and this seems to be effective in squamous cell carcinoma 8 . In patients with advanced cervical adenocarcinoma, the prognostic significance of these factors is generally accepted 6,17 .…”

Section: Discussionmentioning

confidence: 99%

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Early invasive cervical adenocarcinoma: its potential for nodal metastasis or recurrence

Hirai

2003

BJOG: An International Journal of Obstetrics and Gynaecology

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“…None of 21 Japanese women with adenocarcinomas invasive to 3 mm or less had recurrences. 52 Early cancers can recur, but they are usually more advanced than FIGO stage IA1. For example, 2 of 36 patients with adenocarcinomas invasive to 3 mm or less had recurrences, but both had tumors that were greater than 7 mm in length, which would be staged as IB1 adenocarcinomas.…”

Section: Microinvasive Adenocarcinomamentioning

confidence: 99%

Microinvasive Carcinoma of the Cervix

Garg¹,

Rabban²,

Chen³

et al. 2006

Pathology Case Reviews

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Superficially invasive cervical carcinomas only infrequently metastasize to regional lymph nodes or recur. A category of superficially invasive carcinoma termed microinvasive carcinoma has been defined, based on clinicopathologic studies of large numbers of superficially invasive squamous cell carcinomas. A microinvasive carcinoma is one that invades to a depth of 3 mm or less, does not invade lymphovascular spaces, and shows 7 mm or less of horizontal spread. Microinvasive squamous cell carcinoma has such a low risk of metastasis or recurrence, 1% or less, that it can be treated conservatively by a cone biopsy with adequate free margins or with a simple hysterectomy, while more deeply invasive carcinomas are often treated by more radical methods. The category of microinvasive carcinoma is widely accepted for squamous cell carcinomas. It is less accepted for adenocarcinomas because fewer cases have been studied, but the studies that have been reported thus far suggest that microinvasive adenocarcinoma may also be amenable to conservative treatment.

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Early Adenocarcinoma of the Uterine Cervix

Cited by 54 publications

References 8 publications

Invasive Endocervical Adenocarcinoma

Invasive Endocervical Adenocarcinoma

Early invasive cervical adenocarcinoma: its potential for nodal metastasis or recurrence

Microinvasive Carcinoma of the Cervix

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