Introduction/Background*Standard surgical treatment of FIGO stage 1B1 cervical cancer is open radical surgery. However, several reports have shown that for small tumours a more conservative approach can be oncologically safe whilst at the same time reducing the morbidity associated with radical hysterectomy. The objective of our study was to report updated survival following extended follow up of a previously reported cohort of patients who underwent conservative management of small-volume stage 1B1 disease.

Methodology All patients with FIGO stage 1B1 cancer and estimated tumour volume of less than 500 mm3 in a loop biopsy specimen treated in Norther Gynaecological Oncology Centre between January 2000 and December 2010, were included in the study, irrespective of other histological characteristics. Clinicopathological data alongside demographics were collated alongside detailed follow-up outcome in conjunction with primary care and death register.

Result(s)*62 women underwent conservative management for small volume stage 1B1 disease. Median age at diagnosis was 35 years (range 25–67). 35 women (56.4%) underwent fertility sparing conservative management with LLETZ while 27 women (44.6%) underwent simple hysterectomy. Mean age of the LLETZ first group was 32 years (range 26–43) and 51% were nulliparous. Overall, 92% (57 out of 62) patients underwent BPND and one positive node was identified. LVSI was positive in 14 patients (22%). Accurate survival data obtained 100% of the patients and no recurrence identified with median follow up of 11years (range 1-20). 2 patients died because of unrelated to cervical CA reasons (bowel CA 4 years post treatment and PE 1year post treatment).

Conclusion*The results of this study were initially published in 2012 with a median FU of 56 months (Biliatis et al. Gynaecologic Oncology 2012). Presenting long term FU data with median FU of 11 years we can strongly support that cervical loop biopsy or simple hysterectomy combined with negative pelvic lymphadenectomy for small-volume stage 1B1 cervical cancer offers excellent prognosis in terms of survival. Should these results be verified by further prospective studies, radical surgery for these women may be avoided.