Introduction/Background FIGO definition from 2009, limits stage IA2 to 5×7 mm, and stage IB1 to a gross tumor diameter of 4 cm. Our study reviews the pathology in 32 cases of stage IA2 and 205 cases of small diameter stage IB1 cervical cancer
Methodology Pathology review was done including the „third dimension’ measure in stage IA2 not exceeding 7 mm and maximal measure in small diameter IB1 not exceeding 20 mm. Therefore exclusion criteria further limited these two groups of patients. The main focus was to emphasize the risk factors contributing to tumor spread.
The disease beyond cervix and defining the spread pathways.
Results Metastatic pelvic nodes were found in 3.1% of patients in stage IA2, and 6,3% in small stage IB1. LVSI was detected in 9,1% in stage IA2, and in 32.2% in small stage IB1 cervical cancer. There were no cases of parametrial involvement in stage IA2, but 12 cases in small stage IB1; 9 in patients with positive and only 3 with negative pelvic nodes. Two of these patients were LVSI positive, and only one LVSI negative with superficial invasion. The risk of parametrial involvement in small IB1 tumors was 0.5% with superficialinvasion and no LVSI. The single most important predicting factor for nodal metastases in both groups was LVSI, 33% of patients in stage IA2, and 84.6% in small stage IB1 had nodes positive. The depth of invasion showed importance only in small diameter IB1 tumors. Tumor volume had no significant impact limited with maximal measures applied.
Conclusion The review shows no risk for parametrial tumor spread in stage IA2 but very low risk in small diameter IB1 tumors. Tumors belonging to different FIGO stages, ie IA2 and IB1 with diameter less than 20 mm seem to be acting biologically closer compared to the two substages of their own stage.
Disclosure Nothing to disclose.
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