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Re: Surgical Pathology ReportFrom: anonymous@obgyn.netWed Nov 28 18:49:45 2007
At Wed, 28 Nov 2007, anonymous wrote: > >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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