Microinvasive adenocarcinoma of the cervix

OBJECTIVE: We compared the outcomes of microinvasive squamous cell carcinoma and adenocarcinoma of the cervix and examined the safety of fertility-conserving treatment. STUDY DESIGN: The Surveillance, Epidemiology, and End Results database was used to identify all women with stage IA1 and IA2 cervical carcinoma diagnosed from 1988 to 2005. The treatment and outcomes of women with adenocarcinomas were compared with squamous cell carcinomas. RESULTS: A total of 3987 women including 988 with adenocarcinomas (24.8%) were identified. Women with adenocarcinoma were more often white and were younger (P<.05 for all). Survival for stage IA1 adeno-carcinomas (hazard ratio, 0.79; 95% confidence interval, 0.21-2.94) was similar to that of women with squamous cell tumors. For stage IA2 tumors, survival was similar for squamous cell and adenocarcinomas (hazard ratio, 0.51; 95% confidence interval, 0.18-1.47). For stage IA1 and IA2 adenocarcinomas, survival was similar for conization and hysterectomy. CONCLUSION: Survival is similar for microinvasive adenocarcinomas and squamous cell carcinomas. Conization appears to be adequate treatment for microinvasive adenocarcinoma.