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Cervical Cancer
Loop Electrosurgical Excision Procedure Findings for Identification of Patients With Early-Stage Cervical Cancer Suitable for Less Radical Surgery
  1. Mi-Kyung Kim, MD*,
  2. Min A Kim, MD, PhD†,
  3. Jae Weon Kim, MD, PhD*,‡,
  4. Hyun Hoon Chung, MD, PhD*,‡,
  5. Noh-Hyun Park, MD, PhD*,
  6. Yong-Sang Song, MD, PhD*,‡,§ and
  7. Soon-Beom Kang, MD, PhD*
  1. *Departments of Obstetrics and Gynecology and
  2. †Departments of Pathology, Seoul National University College of Medicine;
  3. ‡Cancer Research Institute, and
  4. §Major in Biomodulation, WCU and Department of Agricultural Biotechnology, Seoul National University, Seoul, Korea.
  1. Address correspondence and reprint requests to Jae Weon Kim, MD, PhD, Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Republic of Korea. E-mail: kjwksh{at}snu.ac.kr.

Abstract

Objective To define a subset of patients with early-stage cervical cancer at low risk for parametrial invasion through pathologic parameters of loop electrosurgical excision procedure (LEEP).

Materials and Methods A retrospective analysis of data from 131 patients who underwent LEEP before radical hysterectomy or radical trachelectomy for stage IA2 to IB1 cervical cancer was performed. Subgroup analysis was performed to define a group of patients at the lowest risk for parametrial invasion based on LEEP findings.

Results Overall, 7 (5.3%) of 131 patients showed parametrial involvement, all of whom had residual tumors in hysterectomy specimens. Risk factors for residual disease included a tumor width greater than 30 mm and a positive endocervical or deep resection margin. A subgroup analysis demonstrated that LEEP parameters, including a depth of invasion of 5 mm or less and a negative endocervical resection margin, were able to define the subgroup of patients at low risk for parametrial invasion. In 24 patients (18.3%) who met these criteria, there was no evidence of parametrial spread as well as nodal metastasis.

Conclusion A subgroup of patients with early-stage cervical cancer selected by the 2 LEEP variables, depth of invasion of 5 mm or less and a negative endocervical resection margin, demonstrated no risk for parametrial invasion.

  • Cervical cancer
  • Conization
  • Parametrial involvement
  • Less radical surgery

https://doi.org/10.1097/IGC.0b013e31825fb63b

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    Footnotes

    • The authors declare no conflicts of interest.