ISSN 2052-6210
Original Research

The efficacy of long term follow-up and CO2 laser conization as conservative management in patients with cervical cancer stage FIGO IA1

Maria Grazia Fallani, Annalisa Pieralli*, Virginia Lozza , Serena Tarani, Claudia Bianchi, Sepideh Sadat Peyrov Sajad, Massimiliano Fambrini and Carlo Penna

*Correspondence: Annalisa Pieralli

These authors contributed equally to this work.

Author Affiliations

Department of Woman and Child Health, Section of Gynecology and Obstetrics, University of Florence, Largo Brambilla 3, 50144 Florence, Italy.


Background: Patients with FIGO (International Federation of Gynaecologists and Obstetricians) stage IA1 cervical squamous carcinoma can be treated conservatively with conization only as alternative to a hysterectomy. The aim of this study was to evaluate the efficacy of laser CO2 excision as therapeutical method for stage IA1 cervical squamous carcinoma.

Methods: Sixty patients were submitted to CO2 laser conization with histologic diagnosis of squamous carcinoma stage FIGO IA1 and then submitted to follow-up with PAP smear, colposcopy and biopsy. Prognostic risk factors for relapse were evaluated with univariate analysis.

Results: Conservative management with laser therapy was effective in more than 90% of the patients. When disease persistence was detected (7%), patients underwent repeated laser CO2 conization and followed-up without demolitive intervention. The risk of disease progression in the case series was 1.8%. Univariate analysis revealed that only depth of stromal invasion was a significant risk factor for relapse (P<0.04). Moreover, depth of stromal invasion between 1-3 mm was the only prognostic factor for relapse with specificity 78%, sensitivity 75% and likelihood positive ratio 3,47.

Conclusion: Laser CO2 conization alone appeared to be an effective and safe treatment for patients with Cervical Cancer Stage FIGO IA1 if careful post-treatment follow-up was guaranteed. The deph of stromal invasion has been confirmed as the most important risk and prognostic factor to be evaluated for disease relapse.

Keywords: Cervical cancer, conservative therapy, conization, microinvasive, stromal invasion

ISSN 2052-6210
Volume 1
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