CARCINOMA OF CERVIX STAGE IA - DIAGNOSIS AND TREATMENT

A total of 177 cases of carcinoma of the cervix Stage IA have been followed-up for 5 to 17 years. Diagnostic procedures in the material consisted of cytologic smears, punch biopsies under colposcopic guidance, and fractionated curettage. The results show that in early invasive carcinomas located in the endocervix only, the diagnosis should be established by conization before ultimate therapy is decided upon. Of 164 squamous cell carcinomas, the frequency of distant spread could be evaluated in 139 cases. In four cases (2.9 per cent) metastases developed during the follow-up period. This seems to be a maximum figure, however, since 2 of the 4 cases with metastases probably should have been allocated to the clinical Stage IB. It is concluded that the potential for spread in true Stage IA lesions is approximately 1 per cent or less, and thus it is found justified not to treat the regional lymph nodes. It is advocated that young women should be treated by a semiradical hysterectomy with preservation of the ovaries, while women near or passed the menopause should be treated by intracavitary radium irradiation only. © 1969.