The value of loop electrosurgical conization in the treatment of stage IA1 microinvasive carcinoma of the uterine cervix

Abstract

The objective of this study is to assess the value of Loop Electrosurgical Conization (LEC) in the treatment of stage IA1 microinvasive squamous cell carcinoma (MIC) of the uterine cervix. Retrospectively, 82 patients with FIGO stage IA1 MIC, primarily treated with LEC on see and treat basis, were analyzed.After the initial LEC, 16 patients received cytologic and colposcopic follow-up only, 66 patients underwent a second procedure (repeat LEC, Cold Knife Conization (CKC), or hysterectomy), and four patients underwent a third procedure (hysterectomy). In 63 patients (77%) no residual CIN 3 or MIC was present after the initial LEC. Treatment of residual CIN 3 or MIC was equally effective with a repeat LEC as with CKC. One patient defaulted follow-up and developed a recurrence in the vaginal vault and was treated with a radical hysterectomy.LEC can be used as an alternative for CKC in treatment of patients with stage IA1 MIC. The advantage of LEC is that it can be performed as an outpatient procedure in addition to a diagnostic colposcopy and does not require a major anesthetic. Only a small number of patients will need a more extensive procedure.

Management of Early-Stage Cervical Cancer: A Literature Review

“…The role of LVSI in the IA1 stage remains a controversial topic. However, most centers recommend RH or radiotherapy if this pathological finding is present [37].…”

Microinvasive Carcinoma of the Cervix

“…45 Nevertheless, the results obtained by cold knife cone and loop conization can be equivalent. 46 The risk of recurrence is only about 1% for adequately treated women with microinvasive carcinoma.…”

Fatores histopatológicos associados à recidiva de doença e sobrevida em mulheres com carcinoma microinvasor de colo uterino estádio IA1

“…Some series report routine use of electrocoagulation, and this could result in decreased detection of residual disease. 26 Another point associated with less residual disease in others studies is the repetition of conization preconized to reach a cone margins negative or free of microinvasive disease to define the accurate stage and possible conservative management. 27 In this study, the repetition of the conization was minimal with only 4 cases by CKC technique after LEEP.…”