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Re: Surgical Pathology ReportFrom: anonymous (anonymous@obgyn.net)Wed Nov 28 18:38:42 2007
At Wed, 28 Nov 2007, Sarah wrote: > I am the original poster of this message, but am unclear on what this response means. I just want to understand if my pathology means I must have a hysterectomy. I am 29 and not yet married and am devastated at the thought of not being able to have children. >Abstract >The clinico-pathologic details of 200 patients with micro-invasive >squamous-cell carcinoma of the cervix have been analyzed. All tumors >invaded 5 mm or less below the basement membrane. One hundred and nine >were categorized as FIGO stage 1a1 (early stromal invasion) and 91 as >FIGO stage 1a2 (micro-carcinoma). The horizontal spread (length) of 12 >micro-carcinomas exceeded 7 mm. Twenty-three had stromal invasion 3 mm >or more, and 22 had capillary-like space involvement. Fifty-eight >patients underwent pelvic lymphadenectomy in addition to hysterectomy >and none had positive nodes. Univariate and multivariate analyses of >possible prognostic factors including depth, horizontal spread, width, >area, volume, grade, growth pattern, capillary-like space involvement, >and stromal reaction failed to show any to be significantly associated >with recurrence. The median duration of follow-up is now 8 years (0–22 >years). Despite complete resection, seven (3.5%) patients developed >recurrence of in situ or invasive carcinoma (three after early stromal >invasion and four after micro-carcinoma), all of which were located at >the vaginal vault. There were two deaths, one due to pulmonary >squamous-cell carcinomatosis 21 years after early stromal invasion, the >connection being tenuous, and the other due to local recurrence. There >have been no recurrences to date in 23 patients treated by conization >alone. The uniformly good prognosis of patients in this study is >attributed to meticulous sampling of operative specimens resulting in >accurate diagnosis and appropriate treatment, which may be conization >alone provided the margins are free, there is no capillary-like space >involvement, and the depth of penetration is less than 3 mm. > >This article is cited by: > >At Wed, 28 Nov 2007, anonymous wrote: >> >>My doctor recently called me to alert me of my pathology report from a >>recent LEEP procedure and I have been referred to a specialist. I have >>a copy of the pathology report and am trying to understand what it >>means. I have done a ton of research and think I understand the >>important questions I need to make sure to ask the specialist, but am >>looking for any additional insight into the findings because they sound >>alarming. Here are my results: >> >>"Endocervix, Leep Excisiion: INVASIVE MODERATE TO POORLY DIFFERENTIATED >>SQUAMOUS CELL CARCINOMA ARISING IN EXTENSIVE SQUAMOUS CELL CARCINOMA IN >>SITU. INVASIVE CARCINOMA AND CARCINOMA IN SITU EXTENSIVELY EXTEND TO >>CAUTERY. >> >>ENDOCERVIX, CURETTAGE: EXTENSIVE SQUAMOUS CELL CARCINOMA IN SITU WITH >>FOCI SUSPICIOUS FOR INVASIVE CARCINOMA. >> >>THE INVASIVE COMPONENT IS PRESENT ON MULTIPLE FRAGMENTS, MULTIFOCALLY >>EXTENDS TO CAUTERIZED MARGINS AND IS PROBABLY MACROINVASIVE (GREATER >>THAN pT1a)."
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