Re-assessment of stage I uterine cervical carcinoma according to revised JSGO (1997) staging.

BACKGROUND: The Japanese Society of Gynecologist and Obstetrician (JSGO) revised criteria for early uterine cervical cancer. OBJECTIVE: In this study, we investigated the value of the revised JSGO criteria. METHOD: Retrospective review was performed for 70 patients with tumors limited to the uterine cervix who were classified stage I under old JSGO criteria. RESULT: Forty patients were re-classified into stage IA1 and 4 patients into stage IA2. Incidence of lymph-vascular infiltration (LVI) in stage IA1 and IA2 were 5% and 25%. There was one patient with stage IA1 disease who had nodal metastasis and no patients with stage IA2 disease. There were 14 patients with stage IB1 disease and 12 patients with stage IB2 disease. Mortality of patients with stage IB2 disease was 25% and significantly higher than that of patients with stage IA and IB1 disease (P<0.001 and <0.05) CONCLUSION: Although the revised JSGO criteria for early cervical cancer are acceptable for assessment of patients, the therapy of patients is still controversial. We recommend that patients with stage IA1 and negative LVI should have less radical hysterectomy and patients with stage IA1 with LVI or stage IA2, IB should have radical hysterectomy.