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Conization Using Electrosurgical Conization and Cold Coagulation for International Federation of Gynecology and Obstetrics Stage IA1 Squamous Cell Carcinomas of the Uterine Cervix
  1. Sun-Joo Lee, MD, PhD*,
  2. Woo Young Kim, MD, PhD,
  3. Jeong-Won Lee, MD, PhD,
  4. Hyoung Sun Kim, MD, PhD,
  5. Yoon-La Choi, MD, PhD,
  6. Geung Hwan Ahn, MD, PhD,
  7. Je-Ho Lee, MD, PhD,
  8. Byoung-Gie Kim, MD, PhD and
  9. Duk-Soo Bae
  1. * Department of Obstetrics and Gynecology, School of Medicine, Konkuk University Hospital, Konkuk University; Departments of
  2. Obstetrics and Gynecology, and
  3. Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
  1. Address correspondence and reprint requests to Byoung-Gie Kim, MD, PhD, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kang-Nam Gu Irwon Dong 50, Seoul, Republic of Korea. E-mail: bgkim{at}smc.samsung.co.kr.

Abstract

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 IA1 squamous cell carcinoma of the cervix and a resection margin free from (micro)invasive carcinoma after conization.

Methods: Patients with stage IA1 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 IA1 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.

  • Microinvasive carcinoma
  • Electrosurgical conization
  • Cold coagulation
  • Resection margin

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Footnotes

  • S.-J. Lee and W.-Y. Kim contributed equally to this work.

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