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Early invasive cervical adenocarcinoma: its potential for nodal metastasis or recurrence
Yasuo Hirai1, Nobuhiro Takeshima, Shinichi Tate
1Department of Gynecology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 1-37-1, Kami-Ikebukuro, Toshima-ku, 170, Tokyo, Japan.
Objective:
To investigate the potential for nodal spread or recurrence in patients with early invasive cervical adenocarcinoma. The possible application of the International Federation of Gynecology and Obstetrics (FIGO) classification (1994) to this variant was also examined.
Design:
Retrospective observational study.
Setting:
Gynaecological oncology division of Cancer Institute Hospital, Japan.
Population:
302 patients with FIGO Stage 0-IIB cervical adenocarcinoma treated surgically at the Cancer Institute Hospital.
Methods:
Clinicopathological analysis was performed on 47 patients with early invasive cervical adenocarcinoma in whom the depth of stromal invasion was 5 mm or less. All patients underwent radical hysterectomy and pelvic lymphadenectomy.
Results:
In 30 patients with a depth of tumour invasion of 3 mm or less, no lymph node metastasis was found, while two patients developed recurrence; one had a depth of invasion of 3 mm and a horizontal tumour spread of 3 mm, and the other had horizontal spread of more than 7 mm. In 17 patients with a depth of invasion from 3 to 5 mm, there was also no lymph node metastasis, but two patients developed recurrence; one had horizontal tumour spread of 7 mm or less, and the other had horizontal spread of more than 7 mm.
Conclusions:
Early invasive cervical adenocarcinoma with a depth of invasion of 3 mm or less and a horizontal spread of 7 mm or less has little potential for nodal metastasis or recurrence. It seems possible that the FIGO definition (1994) of early cervical cancer may be applicable in its present form to early cervical adenocarcinoma.