An evaluation of 721 women with Stage IA1 cervical cancer: is conservative surgical approach safe?

Objective: To assess the outcomes of women with Stage IA1 cervical cancer received conization, simple hysterectomy (Class I/Type A), modified radical hysterectomy (Class II/Type B), radical hysterectomy (Class III/Type C), and identify the pathologic characteristics after conization which might correlate with the residual disease in cervix uteri. Materials and Methods: A cohort of 721 Stage IA1 cervical cancer patients treated in the present hospital from January 2005 to December 2014 were evaluated retrospectively. Clinical parameters from the patients underwent conization and three types of hysterectomies as definitive surgery were compared, and pathologic characteristics from patients receiving diagnostic conization before hysterectomy were also analyzed. Results: The conization outperformed three types of hysterectomy in aspects of significant shorter operating time, less blood loss, and shorter urinary catheterization time and hospital stay. However, incidences of perioperative complication and recurrence were comparable among different surgical approaches. Positive margin status and lymphovascular space invasion (LVSI), rather than pathology of conization, the higher level pathology between biopsy and conization, scope of surgery, and pathologic subtype, were significantly associated with the residual disease in hysterectomy specimens. Conclusion: There was no distinction between prognosis of conization and three types of hysterectomy for Stage IA1 cervical cancer patients. Margin status of conization and LVSI might predict the residual disease in cervix uteri.

Stage IA1; Cervical cancer; Conization; Hysterectomy; Margin status; LVSI.

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