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EP382 Regular follow up with cervical/vault cytology is of questionable value in patients treated for microinvasive cervical cancer
  1. S Hirsi-Farah,
  2. S Kerai,
  3. S Abdul,
  4. O Tamizian,
  5. V Asher,
  6. A Bali and
  7. A Phillips
  1. University Hospitals of Derby and Burton, Derby, UK


Introduction/Background Follow up for women treated for microinvasive cervical cancer depends on stage at diagnosis. The BSCCCP states, for completeness, that women treated with fertility preserving surgery for stage 1a1 disease could be offered cervical cytology at 6 and 12 months and yearly for 9 years. Stage 1a1 treated with hysterectomy or 1a2 disease follow up is determined by gynaecological oncologist and local cancer pathways. We aimed to assess the value of various follow up regimes in these patients.

Methodology A retrospective review of all patients treated for Stage 1a1 and 1a2 cervical cancer from 01/2002–12/2018 at the University Hospitals of Derby and Burton (UHDB) identified from the hospital databases. Only patients with squamous or cervical adenocarcinomas were included.

Results 101 cases were identified. 84(83.2%) were stage 1a1 and 17(16.8%) were stage 1a2. 75(74.3%) had squamous histology and 26(25.7%) had cervical adenocarcinomas. Median follow up was 64 months.

Only one (1%) case of occult microinvasive cancer was identified post-hysterectomy for presumed benign disease, the other 100 (99%) patients were diagnosed/treated with conservative/fertility sparing procedures. A second procedure due to involved/close margins with cancer/persistent precancer was performed in 75 (74.25%) cases, of these, 50 (66.67%) had conservative/fertility sparing procedures and 25 (33.33%) had hysterectomy. Residual cancer was found in 3(4%) of second treatment specimens.

Of patients followed up with vault smears all 45(100%) smears were negative.

For patients treated conservatively (68 1a1 and 7 1a2) 377 smears were performed. 338 (89.67%) were negative, 8 (2.1%) borderline, 27 (7.2%) inadequate, two (0.5%) low grade and two (0.5%) high grade.

Of the two high grade smears only one required a LLETZ that demonstrated CIN3. No cases of recurrent cancer were identified. Only 1/75 (1.3%) of patients treated conservatively had recurrent CIN2/3/CGIN.

Conclusion Microinvasive cervical cancer is effectively treated with conservative surgery and reducing the intensity of follow of these patients should be considered.

Disclosure Nothing to disclose.

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