Population-based study of microinvasive adenocarcinoma of the uterine cervix

Objective: To analyze lymph node status and survival rates of women with mi croinvasive cervical adenocarcinoma (International Federation of Gynecology and Obstetrics stages IA(1) and IA(2)). Methods: The Surveillance, Epidemiology, and End Results (SEER) Public-Use Database was used to identify cases of microinvasive cervical adenocarcinom a diagnosed between 1988 and 1997. Variables analyzed included stage, exten t of surgery, lymph node status, radiation therapy, and age. Statistics inc luded analysis of trends, analysis of variance, log-rank test, one-sided bi nomial confidence interval estimation, and power analysis. Results: Among 301 reported cases, 131 had stage IA(1) and 170 IA(2) diseas e. Simple hysterectomies were done in 54 women with IA(1) and 64 with IA(2) disease and radical hysterectomies were done in 50 and 83 women, respectiv ely. Only one of 140 women who had lymphadenectomy had a single positive ly mph node. There were four tumor-related deaths tone with IA(2), and three w ith IA(2) disease). There were no deaths among 96 women (47, IA(1); 49, IA( 2)) treated by simple hysterectomy alone. The mean follow-up was 46.5 month s (range 1-119). The censored survival rate was 98.7% overall (99.2% IA(1), 98.2% IA(2)). Power analysis estimated that 720 patients would be required in each group to detect a 2% difference in survival. Using one-sided 95% c onfidence interval estimations, the risk-adverse events rate for IA(1) was no more than 3.57%, and 4.50% for IA(2) disease. Conclusion: Prognosis is excellent for microinvasive adenocarcinoma of the uterine cervix. In 96 cases (31.9%), simple hysterectomy alone proved adequ ate. (Obstet Gynecol 2001; 97:701-6. (C) 2001 by The American College of Ob stetricians and Gynecologists.).