Multifocal FIGO Stage IA1 Squamous Carcinoma of the Cervix: Criteria for Identification, Staging, and its Good Clinical Outcome

被引:13
作者
Day, Elizabeth [1 ]
Duffy, Siobhan [1 ]
Bryson, Gareth [2 ]
Syed, Sheeba
Shanbhag, Smruta
Burton, Kevin [3 ]
Lindsay, Rhona [3 ]
Siddiqui, Nadeem [3 ]
Millan, David [2 ]
机构
[1] NHS Greater Glasgow & Clyde, Glasgow, Lanark, Scotland
[2] Queen Elizabeth Univ Hosp, Dept Pathol, 1345 Govan Rd, Glasgow G51 4TF, Lanark, Scotland
[3] Princess Royal Matern Hosp, Dept Gynaecol Oncol, Glasgow, Lanark, Scotland
关键词
Cervix; Squamous carcinoma; Multifocal; UTERINE CERVIX; CELL CARCINOMA; MICROINVASIVE CARCINOMA; TREATMENT MODALITIES; STROMAL INVASION; RADICAL SURGERY; CANCER; LESIONS; MANAGEMENT; PROGNOSIS;
D O I
10.1097/PGP.0000000000000269
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Multifocal squamous cervical carcinomas account for up to 25% of IA1 tumors identified on excisional biopsy, yet there are no uniformly accepted histopathologic criteria for defining and staging these lesions. Here, we use a strict case definition and meticulous specimen processing from colposcopist to pathologist to identify and follow-up 25 cases of multifocal IA1 cervical squamous carcinomas identified in excisional biopsies. We stage these tumors using the dimensions of the largest focus and a minimum of 2 mm between each foci to define multifocality. The cases are followed up for a median of 7 yr with no episodes of tumor recurrence or metastasis. We also show that the prevalence of residual preinvasive (20%) and invasive disease (5%) on repeat excision/surgery are comparable to data available for unifocal IA1 cases. Our study supports the hypothesis that multifocal lesions should be staged according to largest individual focus of invasion and we emphasize the importance of meticulous specimen handling to appropriately identify multifocal tumors. In addition, our analysis suggests that outcomes are comparable to unifocal lesions and supports the hypothesis that they may be managed in a similar manner.
引用
收藏
页码:467 / 474
页数:8
相关论文
共 31 条
  • [1] [Anonymous], AM J OBSTET GYNECOL
  • [2] AVERETTE HE, 1976, CANCER-AM CANCER SOC, V38, P414, DOI 10.1002/1097-0142(197607)38:1<414::AID-CNCR2820380165>3.0.CO
  • [3] 2-S
  • [4] Small volume stage 1B1 cervical cancer Is radical surgery still necessary?
    Biliatis, Ioannis
    Kucukmetin, Ali
    Patel, Amit
    Ratnavelu, Nithya
    Cross, Paul
    Chattopadhyay, Supratik
    Galaal, Khadra
    Naik, Raj
    [J]. GYNECOLOGIC ONCOLOGY, 2012, 126 (01) : 73 - 77
  • [5] Braakhuis BJM, 2003, CANCER RES, V63, P1727
  • [6] BURGHARDT E, 1992, CANCER, V70, P648, DOI 10.1002/1097-0142(19920801)70:3<648::AID-CNCR2820700318>3.0.CO
  • [7] 2-R
  • [8] Chai H, 2009, ANN CLIN LAB SCI, V39, P331
  • [9] Cervical cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    Colombo, N.
    Carinelli, S.
    Colombo, A.
    Marini, C.
    Rollo, D.
    Sessa, C.
    [J]. ANNALS OF ONCOLOGY, 2012, 23 : 27 - 32
  • [10] The Lower Anogenital Squamous Terminology Standardization Project for HPV-associated Lesions: Background and Consensus Recommendations From the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology
    Darragh, Teresa M.
    Colgan, Terence J.
    Cox, J. Thomas
    Heller, Debra S.
    Henry, Michael R.
    Luff, Ronald D.
    McCalmont, Timothy
    Nayar, Ritu
    Palefsky, Joel M.
    Stoler, Mark H.
    Wilkinson, Edward J.
    Zaino, Richard J.
    Wilbur, David C.
    [J]. INTERNATIONAL JOURNAL OF GYNECOLOGICAL PATHOLOGY, 2013, 32 (01) : 76 - 115