A Clinicopathological Analysis of Stage I a Cancer of Uterine Cervix

Lee, S M; Noh, S H; Ahn, J M; Kim, D H; Park, E D

Abstract

In 1995 the Cancer Committee of the International Federation of Obstetrics and Gynecology (FIGO) subdivided stage Ia cervical cancer into stage Ia1, tumor which invades the cervical stroma to a depth of 3.0 mm or less, and stage Ia2, tumor which invades the cervical stroma to a depth of 3.0~5.0 mm and a horizontal spread of 7 mm or less. We conducted this retrospective study in order to evaluate the result of therapeutic approach in patient with stage Ia cervical cancer. From January 1987 to December 1996, we have experienced 177 cases with stage Ia cervical cancer, which consist of 161 cases of stage Ia1 and 16 cases of stage Ia2. The age ranged from 26 to 68 years and median age was 43.1 years. In 177 cases, 139 cases were premenopause and 38 cases were postmenopause state and mean parity was 2.8. 70 cases (39.6%) incidentally found through the routine Pap smear, in symptomatic group most frequent initiating symptom was vaginal spotting (33.3%). Pap smear was done in 168 cases, the result reveals CIN III in 45.8% and carcinoma in 36.9%. The corresponding rate of Pap smear to histologic diagnosis was 36.9% and within one histologic grade was 82.7%. The type I hysterectomy was performed in 131 cases of stage Ia1 disease and 6 cases of stage Ia2 disease. Type II hysterectomy was done in 24 cases and 10 cases of Ia1 and Ia2 disease, respectively. 3 cases of Ia1 disease were treated by therapeutic conization. Four patients recurred during the median follow up of 42 months (range 8~113 months), but there was no cancer or treatment related death. In conclusion, the prognosis of stage Ia cervical cancer is relatively good and less radical therapeutic approach may be beneficial. But futher study will be necessary.