Surgical approach and long-term clinical outcome in women with microinvasive cervical cancer

Aim: To assess the efficacy and safety of conservative surgical approach for microinvasive cervical cancer with regards to cone margins status and lymph vascular space invasion (LVSI).

Patients and methods: This was a multicentre retrospective cohort study of 153 women diagnosed with microinvasive cervical cancer over a 10 years period (1993-2003).

Results: In conservatively-treated women (n=80), neither cancer mortality nor disease relapse after 184.5 ± 20.5 months of follow-up was detected. Residual disease in women who underwent secondary surgery was significantly related to positive margins on the primary cone excision (p=0.005) while no correlation with LVSI emerged.

Conclusion: Conization can represent the definitive treatment for stage IA1, if surgical margins are cancer-free, independently of LVSI. A conservative surgical approach could also be considered in women with IA2 cervical cancer when preservation of fertility is strongly requested. A close long-term surveillance should be scheduled for conservatively-treated women.