Organsaving treatment of microinvasive cervical cancer of Т1A1stage

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Introduction. Now the cervical cancer wins first place in the world and the second main place in the Russian Federation among all malignant new growths of female genitals. Thus in our country, on the average only at 10% of patients fixed preinvasive stage of tumoral process, that is absolutely inadequate to opportunities of modem medicine and testifies to a low level of screening. The analysis of age structure of microinvasive cervical carcinoma patients, led in the middle of 80th years of the last century, has shown, that it basically of the woman of 40-49 years, i.e. the most active creative and able-bodied age. Now the adequate and standard volume of surgical intervention at micro- invasive cervical cancer T₁A₁ stages is simple gysterectomy without ovarioectomy at women of reproductive age and with ovarioectomy - at patients over 50 years . And, only at women of genital age, at persevering desire of the patient to keep fertility, surgical intervention in a similar situation can be limited of cervix conysation or cervix amputation. At the same time, for last years in the domestic and foreign literature there was published the significant number of works in which the opportunity of organsaving treatments carrying out in patients with the given pathology was substantiated. Besides biological features and a rarity metastasis of microinvasive cervical cancer, the essential argument for reduction of volume of medical influences is extremely high frequency of 5-years recovery - 96,8% on the average for all methods. Besides many authors fairly mark a plenty of complications after application of radical programs of cervical cancer treatment.

Material and methods. For the period from 1983 till 2002 in oncogynaecological department of N.N.Petrov scientific research institute of oncology 177 patients with diagnosis of cervical cancer of IA1 stage had been surveyed and treated. Further all of them have been subjected of dynamic supervision during the period from 3 till 10 years, at average term of observation - 5 years.

Results. 120 patients (67,9%) was at age group till 49 years. More than at half patients (54,2%) the disease proceeded latently, and was located on ectocervix (69,5%). Squamosus changes were revealed in 92,1% of cases, adenogenius - in 6,2%, and, only in 1,7% of cases were revealed adenosquamosus changes. Uterine cervix conization was executed in 42 patients, hysterectomy was made at 51 patients and 84 patients had been subjected of Werthaim operation. The 5-years DFS was: 97,62% in case of uterine cervix conization, 96,08% - at hysterectomy, and 98,81% - in group of patients after Werthaim operation. Statistical comparison of parameters of the 5-years DFS depending on a kind of treatment was not revealed authentic distinctions.

Conclusions. This results allow to recommend to use organsaving operations as the basic method of treatment of microinvasive cervical cancer of Т₁A₁ stages.

About the authors

Е. D. Gershfeld

Author for correspondence.
Email: info@eco-vector.com
Russian Federation, Saint Petersburg

S. J. Maksimov

Email: info@eco-vector.com
Russian Federation, Saint Petersburg

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