Clinical outcome of patients with FIGO stage IA2 squamous cell carcinoma of the uterine cervix

Objective

The objective of this analysis was to present the clinical outcome of the patients with FIGO stage IA2 squamous cell cervical cancer treated at the Department of Obstetrics and Gynecology between 1973 and 2009, and to clarify the discrepancies in clinical guidelines regarding the radicality of treatment applied in patients with stage IA2 squamous cell cervical cancer.

Methods

In our study we enrolled 89 women, diagnosed with FIGO stage IA2 squamous cell microinvasive carcinoma (MIC) in the period 1973-2009. The analysis involved the following parameters women's age at operation, type of operation, cell type, mitotic activity, invasive growth pattern, host defense reaction, lymph-vascular space invasion and patient's survival. Additionally, using the Rainer′s scoring system, the prognostic score for each MIC was calculated.

Results

The mean women's age at operation was 41.48 ± 10.67 years. The mean depth of invasion was 3.09 ± 1.13 mm, and the mean area of carcinoma 4.05 ± 2.40 mm². In 66 (74.2%) women the suggested treatment was conization, according to the Rainer's scoring system and individualization of treatment based on decision of the tumor board. Three of the 89 patients diagnosed with MIC stage IA2 died; only in one patient the cause of death was cervical carcinoma. At the end of the observed period the survival rate was 98.0%.

Conclusion

We may conclude that conservative management of stage IA2 MIC is safe when exact evaluation of tumor extension and surgical margins of the cone are considered, and results in very low risk of recurrence, lymph node disease, and death caused by cancer. We believe that our experience will contribute to the achievement of the international consensus concerning the treatment of IA2 MIC.