Conization Using Electrosurgical Conization and Cold Coagulation for International Federation of Gynecology and Obstetrics Stage IA1 Squamous Cell Carcinomas of the Uterine Cervix
Conization Using Electrosurgical Conization and Cold Coagulation for International Federation of Gynecology and Obstetrics Stage IA1 Squamous Cell Carcinomas of the Uterine Cervix
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DOI：
10.1111/igc.0b013e3181a1a297
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发表时间：
2009-04-01
影响因子：
4.8
通讯作者：
Bae, Duk-Soo
中科院分区：
文献类型：
--
作者：
Lee, Sun-Joo;Kim, Woo Young;Bae, Duk-Soo
目的：本研究旨在评估电切锥切术和冷凝固术作为国际妇产科联盟IA（1）期宫颈鳞状细胞癌患者的确定性治疗方法的有效性和可行性，锥切术后切缘无（微）浸润癌。IA（1）期宫颈鳞状细胞癌患者，无淋巴血管间隙侵犯，已接受电外科锥切和冷凝固治疗，并希望保留生育能力（或仅行保守治疗）均随访，未行进一步手术干预。切除边缘有浸润性或微浸润性癌或宫颈内切除边缘阳性的患者被排除在研究之外。定期进行宫颈阴道涂片和阴道镜检查。疾病复发被定义为宫颈上皮内瘤变2或更高级别的lesions.Results的组织学诊断：共85例患者被认为有资格参与这项研究。中位随访期为81.0个月（范围：13-127个月）。85例患者中有19例有外切缘。有1例复发，这是淋巴结阳性浸润癌复发（1.2%，1/85），在患者阴性切除margins.Conclusions：这些结果表明，电锥切术与冷凝固是一种可行的治疗方法，可作为一个明确的治疗IA期（1）宫颈鳞状细胞癌无淋巴血管间隙的侵犯。此外，在宫颈外切缘有宫颈上皮内瘤变2和3的患者可以在锥切和冷凝固后仔细随访，无需进一步治疗。
Objective: This study was performed to evaluate the efficacy and feasibility of electrosurgical conization and cold coagulation as definitive treatments for patients with International Federation of Gynecology and Obstetrics stage IA(1) squamous cell carcinoma of the cervix and a resection margin free from (micro)invasive carcinoma after conization.Methods: Patients with stage IA(1) cervical squamous cell carcinoma without lymphovascular space invasion who had been treated by electrosurgical conization and cold coagulation and who wanted to preserve fertility (or only undertake conservative treatment) were followed up without further surgical intervention. Patients with invasive or microinvasive carcinoma at resection margins or positive endocervical resection margins were excluded from the study. Cervicovaginal smears and colposcopic examination were performed at regular intervals. Disease recurrence was defined as a histologic diagnosis of cervical intraepithelial neoplasia 2 or higher-grade lesions.Results: A total of 85 patients enrolled were deemed eligible to be involved in the Study. The median follow-up period was 81.0 months (range, 13-127 months). Nineteen of the 85 patients had exocervical resection margins. There was one case of recurrence, which was node-positive invasive cancer recurrence (1.2%, 1/85), in patients with negative resection margins.Conclusions: These results suggest that electrosurgical conization with cold coagulation is a feasible treatment and could be used as a definitive therapy for patients with stage IA(1) cervical squamous cell carcinoma without lymphovascular space invasion. In addition, patients having cervical intraepithelial neoplasias 2 and 3 at exocervical resection margins could be followed up carefully without further treatment after conization and cold coagulation.