Avaliação da abordagem terapeutica no carcinoma la1 do colo uterino

AUTOR(ES)
DATA DE PUBLICAÇÃO

2002

RESUMO

OBJECTIVES: to evaluate post-conization management according to surgical margins, the depth of invasion, glandular extension, recurrence rate and the disease-free period in women with Stage IA 1 cervical microinvasive carcinoma. SUBJECTS AND METHODS: a descriptive study with 104 women diagnosed with Stage IA 1 cervical microinvasive carcinoma, attended and treated at CAISM, UNICAMP from 1992 to 2001, who were followed up for two years or more. The association between the patient s age, histologic characteristics of the lesion (eg, the depth of invasion, glandular extension and surgical margins), type of cervical conization (via cold knife or LEEP), and post-conization management (with follow up ar hysterectomy) and the disease-free period were evaluated. Data were evaluated using the Fisher exact test, Kaplan-Meier curves and the Wilcoxon test for survival analysis. RESUL TS: Of the 104 women evaluated, 61 (58%) underwent hysterectomy after conization and 43 (42%) were submitted solely to follow-up. Treatment with uterine conservation was more frequent in younger women, up to 35 years of age (p=0.005). Ali patients presenting with compromised margins on conization evolved to hysterectomy. It was observed that 42,4% of the patients with cervical stromal invasion up to 1 mm in depth and 36,9% of those with cervical stromal invasion more than 1 mm in depth and up to 3 mm in depth were treated solely with conization (p=0.34). Conservative treatment preserving the uterus was performed in half of women with no glandular extension and in one third of those with glandular extension (p=0.26). The recurrence rate in women submitted to treatment solely with conization was 11.6% against 4.9% of patients submitted to hysterectomy, which was not a significant difference (p=0.27). Recurrences tended to occur earlier in women submitted to conservative treatment (p=0.05). CONCLUSION: Conservative management with uterine conservation is a feasible treatment for women with Stage IA 1 cervical carcinoma and may be an effective alternative treatment for women with negative margins on conization and an adequate follow-up

ASSUNTO(S)

cancer colo uterino tratamento cirurgico

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