ABSTRACT
OBJECTIVE: This study was performed to evaluate the results of conization by loop electrosurgical excision procedure (LEEP) and cold coagulation as a definitive treatment in the patients with FIGO stage Ia1 squamous cell carcinoma of the cervix. METHODS: One hundred eighty-seven patients were diagnosed as stage Ia1 cervical squamous cell carcinomas from 1995 to 2004 by conization with LEEP and cold coagulation. Fifty-nine patients who wanted to preserve fertility and/or refused further surgical treatment were followed-up without further treatment. Eleven patients of the 59 had involved ectocervical resection margins. All patients were followed-up with cervicovaginal smear and colposcopic examination at a regular interval. Disease recurrence was defined as a histologic diagnosis of dysplasia or more. RESULTS: The median follow-up period was 69.0 months (range 8 to 103). All 59 patients had no lymphvascular space invasion (LVSI). In four patients, the ectocervical margins were involved by dysplasia, in seven patients, by carcinoma in-situ. There were no specific differences in ages, depth of stromal invasion and HPV status between the groups with and without involved margins. All 59 patients did not recur during follow-up period. CONCLUSION: Conization with LEEP and cold coagulation was feasible and could be used as a definitive therapy for the patients with stage Ia1 cervical squamous cell carcinoma. This study suggests that conization might play a role in a patient with positive margins (dysplasia or CIS) when LVSI is not demonstrated.