Distribution Pattern of Circumflex Iliac Node Distal to the External Iliac Node Metastasis in Stage IA to IIA Cervical Carcinoma

2014 ◽  
Vol 24 (5) ◽  
pp. 935-940 ◽  
Author(s):  
Yue-ju Yin ◽  
Hui-qin Li ◽  
Xiu-gui Sheng ◽  
Xing-lan Li ◽  
Xiang Wang
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Univariate Analysis ◽  
Operation Time ◽  
Binary Logistic Regression Analysis ◽  
Surgical Morbidity ◽  
Metastatic Rate ◽  
Gynecology And Obstetrics ◽  
Iliac Node ◽  
Stage Ia

ObjectivesThis study aimed to investigate the metastatic rate of circumflex iliac node distal to the external iliac node (CINDEIN) and its associations with clinicopathological factors in patients with stage IA to IIA cervical cancer to determine whether dissection of CINDEIN had a role in surgery of these patients.MethodsSix hundred thirty-three patients with the International Federation of Gynecology and Obstetrics stage IA to IIA cervical cancer who underwent radical hysterectomy and pelvic lymphadenectomy were retrospectively reviewed. The metastatic rate and distribution of the pelvic lymph nodes (PLNs) and CINDEINs were analyzed.ResultsThe PLN metastatic rate was 25.6% (162 of 633 patients). Sixteen of 162 node-positive patients had CINDEIN metastases. Only 1 patient without PLN metastases had positive CINDEIN nodes. Univariate analysis revealed that other PLNs (including lymph nodes collected from obturator, external iliac, and internal iliac regions) and lymph vascular space involvement were the risk factors of CINDEIN metastases (P < 0.05). Other PLN metastasis (odds ratio, 50.6; 95% confidence interval, 6.6–386.7) was an independent risk factor for metastasis to CINDEIN by binary logistic regression analysis.ConclusionsCircumflex iliac node distal to the external iliac node metastases seemed to occur secondarily to widespread PLN metastases. In early stage cervical cancer, removal of the CINDEIN as a routine surgical procedure might be omitted to reduce operation time and minimize surgical morbidity.

Analysis of Patients With Stage IIIC Endometrial Cancer

2014 ◽  
Vol 24 (6) ◽  
pp. 1033-1041 ◽  
Author(s):  
Taner Turan ◽  
Isin Ureyen ◽  
Ipek Duzguner ◽  
Enis Ozkaya ◽  
Tolga Tasci ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Prognostic Factor ◽  
Lymph Nodes ◽  
Univariate Analysis ◽  
Independent Prognostic Factor ◽  
Stage Iiic ◽  
Metastatic Lymph Nodes ◽  
Systematic Lymphadenectomy ◽  
Metastatic Lymph ◽  
Gynecology And Obstetrics

ObjectiveWe aimed to define the factors that are related to recurrence and survival in patients with stage IIIC endometrial carcinoma in this study.Materials and MethodsA total of 147 patients who underwent staging surgery and had a diagnosis of stage IIIC1 to IIIC2 endometrial cancer according to the International Federation of Gynecology and Obstetrics 2009 were included. Patients whose data could not be obtained and patients with a diagnosis of uterine sarcoma and with synchronous tumors were excluded.ResultsMean age of the patients was 58.6 years. Among these patients, 63 had stage IIIC1 and 84 had stage IIIC2 disease. Extrauterine spread was detected in 22% of the patients. Median number of paraaortic (PA) and pelvic lymph nodes removed were 16.5 and 38, respectively. Paraaortic and pelvic nodal involvements were detected in 84 patients and 125 patients, respectively. Radiotherapy was applied more commonly as an adjuvant therapy. Three-year progression-free survival (PFS) and 3-year disease-specific survival (DSS) were 65% and 84%, respectively. Seventy percent of the recurrences were outside the pelvis. Site of metastatic lymph nodes and the number of metastatic PA lymph nodes were associated with 3-year PFS and lymphovascular space invasion; site of metastatic lymph nodes and the presence of recurrence were associated with 3-year DSS in the univariate analysis. Although any surgicopathological factor was not related to 3-year PFS, only the presence of recurrence was an independent prognostic factor for a 3-year DSS in the multivariate analysis (hazard ratio, 0.017; 95% confidence interval, 0.002–0.183).ConclusionsThe number of debulked metastatic lymph nodes and PA involvement were associated with recurrence in the univariate analysis. The presence of recurrence was the only independent prognostic factor detecting survival. Therefore, systematic lymphadenectomy involving PA lymph nodes instead of sampling should be performed in patients with high risk for nodal involvement in endometrial cancer.

scholarly journals UGT1A1 polymorphism has a prognostic effect in patients with stage IB or II uterine cervical cancer and one or no metastatic pelvic nodes receiving irinotecan chemotherapy

2020 ◽  
Author(s):  
Hideki Matsuoka ◽  
Ryusuke Murakami ◽  
Kaoru Abiko ◽  
Ken Yamaguchi ◽  
Akihito Horie ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Side Effects ◽  
Lymph Nodes ◽  
Progression Free Survival ◽  
Conditional Inference ◽  
Free Survival ◽  
Metastatic Lymph Nodes ◽  
Ugt1a1 Polymorphism ◽  
Metastatic Lymph ◽  
Gynecology And Obstetrics

Abstract Background : Uridine diphosphate glucuronosyltransferase 1 family polypeptide A1 (UGT1A1 ) is a predictive biomarker for the side-effects of irinotecan; irinotecan chemotherapy reduces the volume of tumors harboring UGT1A1 polymorphisms. We aimed to determine whether UGT1A1 polymorphisms can predict progression-free survival in patients with local cervical cancer treated with irinotecan. Methods : We retrospectively analyzed the data of 51 patients with cervical cancer treated at a single institution between 2010 and 2015. All patients were diagnosed with the 2009 International Federation of Gynecology and Obstetrics (FIGO) stage IB1, IB2, IIA, or IIB squamous cell carcinoma, underwent radical hysterectomy, and received irinotecan chemotherapy as neoadjuvant and/or adjuvant treatment. All patients were examined for irinotecan side effects using UGT1A1 tests. Conditional inference tree and survival analyses were performed considering stage, age, UGT1A1 status, and the number of metastatic lymph nodes to determine primary factors associated with progression-free survival. Results : The tree-structured survival model determined high recurrence-risk factors related to progression-free survival. The most relevant factor was ≥2 metastatic lymph nodes (p = 0.004). The second most relevant was UGT1A1 genotype (p = 0.024). Among patients with ≤1 metastatic lymph node, those with UGT1A1 polymorphisms benefited from irinotecan chemotherapy and demonstrated significantly longer progression-free survival (p = 0.020) than those with wild-type UGT1A1 . Conclusion : Irinotecan chemotherapy has the potential to benefit patients with cervical cancer, UGT1A1 polymorphism, and ≤1 metastatic lymph nodes.

Oncologic and obstetric outcomes after simple conization for fertility-sparing surgery in FIGO 2018 stage IB1 cervical cancer

2021 ◽  
Vol 31 (3) ◽  
pp. 452-456
Author(s):  
Francesco Fanfani ◽  
Luigi Pedone Anchora ◽  
Giampaolo Di Martino ◽  
Nicolò Bizzarri ◽  
Maria Letizia Di Meo ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Early Stage ◽  
Fetal Loss ◽  
Disease Free Survival ◽  
Figo Stage ◽  
Oncologic Outcomes ◽  
Obstetric Outcomes ◽  
Gynecology And Obstetrics ◽  
Fertility Sparing

ObjectiveConization/simple trachelectomy is feasible in patients with early-stage cervical cancer. Retrospective data suggest that conization with negative lymph nodes could be a safe option for these patients. This study aims to provide oncologic and obstetric outcomes of a large series of patients with 2018 International Federation of Gynecology and Obstetrics (FIGO) stage IB1 cervical cancer managed by conization.MethodsPatients with early cervical cancer and a desire to preserve fertility who underwent conization and pelvic lymphadenectomy from January 1993 to December 2019 in two Italian centers were included. Inclusion criteria were: age >18 years and ≤45 years, 2018 FIGO stage IB1, no prior irradiation or chemotherapy, absence of pre-operative radiologic evidence of nodal metastases, a strong desire to preserve fertility, and absence of concomitant malignancies. We excluded patients with confirmed infertility, neuroendocrine tumor, clear cell or mucinous carcinoma.ResultsA total of 42 patients were included. The median age was 32 years (range 19–44) and median tumor size was 11 mm (range 8–20). Squamous cell carcinoma was found in 27 (64.3%). Grade 3 tumor was present in 7 (16.7%) patients and lymphovascular space involvement was detected in 15 (35.7%). At a median follow-up of 54 months (range 1–185), all patients were alive without evidence of disease. In the entire series three patients experienced recurrence resulting in an overall recurrence rate of 7.1%. All the recurrences occurred in the pelvis (2 in the cervix and 1 in the lymph nodes), resulting in a 3-year disease-free survival of 91.6%. Twenty-two (52%) patients tried to conceive; 18 pregnancies occurred in 17 patients and 12 live births were reported (6 pre-term and 6 term pregnancies). Two miscarriages were recorded, one first trimester and one second trimester fetal loss.ConclusionsOur study showed that conization is feasible for the conservative management of women with stage IB1 cervical cancer desiring fertility. Oncologic outcomes appear favorable in this series of patients. Future prospective studies will hopefully provide further insight into this important question.

Robot-Assisted Radical Hysterectomy in Cervical Carcinoma: The Belgian Experience

2015 ◽  
Vol 25 (9) ◽  
pp. 1690-1696 ◽  
Author(s):  
An Segaert ◽  
Koen Traen ◽  
Philippe Van Trappen ◽  
Frederik Peeters ◽  
Karin Leunen ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Oncological Outcome ◽  
International Federation ◽  
Adjuvant Radiation ◽  
Robot Assisted ◽  
Gynecology And Obstetrics ◽  
Stage Ia ◽  
Disease Free

ObjectiveThe purpose of this study was to report the experience and oncological outcome of robot-assisted radical hysterectomies (RRHs) for cervical cancer performed in Belgium.MethodsPatients undergoing RRH for cervical cancer (n = 109) were prospectively collected between July 2007 and April 2014 in the 5 Belgian centers performing RRH for cervical cancer.ResultsThe median age of the patients was 46 years (range, 31–80 years). Histological types included squamous cell carcinoma in 61 patients, adenocarcinoma in 22 patients, adenosquamous in 8 patients, endometrioid carcinoma in 2 patients, and other types (n = 16). The International Federation of Gynecology and Obstetrics stage distribution was IA (n = 9), stage IB1 (n = 71), stage IB2 (n = 4), stage II (n = 24), and unknown (n = 1). Twenty-four patients received adjuvant therapy, 17 patients underwent radiochemotherapy, and 7 underwent adjuvant radiation. Eighteen patients relapsed, and 5 died of disease. The median follow-up was 27.5 months (range, 3–82 months). The 2- and 5-year overall survivals were 96% and 89%, respectively. The 2- and 5-year disease-free survivals (DFSs) were 88% and 72%, respectively. The 2-year DFS per stage was 100% for IA, 88% for IB1, 100% for IB2, and 83% for II. The 5-year DFS per stage was 100% for stage IA and 75% for IB1. The complications were as expected for radical hysterectomy.ConclusionsThis series confirms the feasibility and safety of RRH not only in cervical cancer stage IA to IB1, but also after neoadjuvant chemotherapy in stage IB2 to IIB.

Comparing Robotic Surgery With Conventional Laparoscopy and Laparotomy for Cervical Cancer Management

2014 ◽  
Vol 24 (6) ◽  
pp. 1105-1111 ◽  
Author(s):  
Ching-Hui Chen ◽  
Li-Hsuan Chiu ◽  
Ching-Wen Chang ◽  
Yuan-Kuei Yen ◽  
Yan-Hua Huang ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Robotic Surgery ◽  
Disease Free Survival ◽  
Operation Time ◽  
Transfusion Rate ◽  
Free Survival ◽  
Pain Scores ◽  
Full Diet ◽  
Stage Ia ◽  
Perioperative Complication

ObjectiveThe aim of this study was to compare the outcomes of robotic surgery, laparoscopy, and laparotomy for the surgical treatment of stage IA to IIB cervical cancer.MethodsThis retrospective study was carried out in a university-affiliated teaching hospital. A total of 100 women with an initial diagnosis of stage IA to IIB cervical cancer, without preoperative brachytherapy or chemotherapy, were included in this study. With selection of the cases, 44 patients received laparotomy surgery, 32 patients received laparoscopic surgery, and 24 patients received robotic surgery. The perioperative parameters measured included operation time, blood loss, transfusion rate, lymph node yield, adhesion score, laparotomy conversion rate, postoperative and 24-hour pain scores, time to full diet resumption, and hospital stay. The perioperative complication and disease-free survival were also evaluated.ResultsThe robotic group showed a shorter operation time, less blood loss, lower transfusion rate, and lower laparotomy conversion rate than the laparoscopic or laparotomy group. As for the postoperative parameters, the robotic group showed reduced postoperative and 24-hour pain scores, shortened length of hospital stay, and decreased time to full diet resumption compared with the other 2 surgical groups. No significant differences were found between the groups in perioperative complication rate or disease-free survival.ConclusionsThe data suggested that robotic surgery is a feasible and potentially optimal option for the treatment of stage IA to IIB cervical cancer with favorable short-term surgical outcomes.

Is Routine Curettage a Useful Tool to Evaluate Persistent Tumor in Patients Who Underwent Primary Chemoradiation for Locally Advanced and/or Lymph Node Positive Cervical Cancer?

2017 ◽  
Vol 27 (6) ◽  
pp. 1216-1221 ◽  
Author(s):  
Simone Marnitz ◽  
Eva Christine Abt ◽  
Peter Martus ◽  
Audrey Tsunoda ◽  
Christhardt Köhler
Keyword(s):  
Cervical Cancer ◽  
Locally Advanced ◽  
Histological Finding ◽  
International Federation ◽  
Positive Finding ◽  
Response Evaluation ◽  
Surgical Morbidity ◽  
Gynecology And Obstetrics ◽  
Impact On Survival

ObjectiveResponse evaluation after primary chemoradiation (RCTX) in patients with cervical cancer remains difficult. Routine hysterectomy after primary RCTX is associated with considerable surgical morbidity without impact on survival. The purpose of the present study was to evaluate value of routine curettage after RCTX to detect persistent tumor.MethodsBetween 2006 and 2012, patients (n = 217) with cervical cancer in International Federation of Gynecology and Obstetrics stages IB1 N1 (14%), IB2 (9%), IIA (5%), IIB (46%), IIIA (4%), IIIB (15%), IVA (6%), and IVB (1%), respectively, underwent primary RCTX. After RCTX, curettage was recommended to all patients to evaluate response.ResultsIn 136 (63%) of patients with cervical cancer, 1 or 2 consecutive curettages were performed at least 6 weeks after primary RCTX without any complications. In 21 (15%) patients, at least 1 curettage was positive for cervical cancer. In 7 patients, secondary hysterectomy was performed after 1 positive finding and persistent tumor was found in all of them. In the remaining 14 patients, there were 2 positive curettages in 5, 1 undetermined result followed by 1 positive in 3, and 1 positive followed by 1 negative in 6 patients, respectively. In the latter group, no tumor was detected in the uterus, whereas in all other patients with 2 curettages except one, residual carcinoma was detected. Five (24%) of 21 patients with positive histology are free of disease during follow-up. Decision for or against secondary hysterectomy was correct due to histological finding of curettage in 99%.ConclusionsRoutine curettage is a useful tool to guide decision for secondary hysterectomy with high accuracy after primary RCTX and avoids overtreatment.

Laparoscopic Lymphadenectomy in Advanced Cervical Cancer: Prognostic and Therapeutic Value

2013 ◽  
Vol 23 (9) ◽  
pp. 1675-1683 ◽  
Author(s):  
Marta del Pino ◽  
Pere Fusté ◽  
Jaume Pahisa ◽  
Àngels Rovirosa ◽  
Maria Jose Martínez-Serrano ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radiation Therapy ◽  
Confidence Interval ◽  
Lymph Nodes ◽  
Locally Advanced ◽  
Advanced Cervical Cancer ◽  
Locally Advanced Cervical Cancer ◽  
Gynecology And Obstetrics ◽  
Therapeutic Value ◽  
Increased Risk

ObjectiveClinical benefit of surgical staging in locally advanced cervical cancer has not yet been proved. The goal of this study was to analyze the prognostic and therapeutic value of laparoscopic para-aortic lymphadenectomy with selective excision of suspicious pelvic nodes in patients with locally advanced cervical cancer.MethodsThis is a retrospective study including 109 women treated in a single institution from 2000 to 2009. The International Federation of Gynecology and Obstetrics stage was IB2 in 12 women, IIB in 58 women, and IIIB in 39 women. None had suspicious para-aortic nodes by presurgical imaging evaluation. All patients underwent extraperitoneal para-aortic laparoscopic lymphadenectomy with selective excision of enlarged pelvic nodes and received pelvic radiotherapy with concomitant chemotherapy. Extended lumboaortic radiation therapy was added to patients with metastatic para-aortic nodes. The mean ± SD follow-up time was 43.1 ± 33.7 months.ResultsMetastatic lymph nodes were identified in 23 (21.1%) of 109 patients in the para-aortic area and in 24 (53.3%) of 45 patients who underwent selective excision of pelvic nodes. Patients with nodal metastases had increased risk of mortality than those with negative nodes independently of the location (pelvic and/or para-aortic) of the metastases (hazard ratio, 4.07; 95% confidence interval, 1.36–12.16 for patients with pelvic metastases [P= 0.012]; and 3.73; 95% confidence interval, 1.38–10.09 for patients with para-aortic metastases [P= 0.010]). In the subset of women with para-aortic metastases treated by extended lumboaortic radiation therapy, neither the number of lymph nodes removed nor the number of positive nodes were associated with survival (P= 0.556 andP= 0.195, respectively).ConclusionPara-aortic and pelvic lymphadenectomy provides valuable information about mortality risk in patients with locally advanced cervical cancer.

scholarly journals Radical hysterectomy in surgical treatment of invasive cervical cancer at the Department of gynecology and obstetrics in Novi Sad in the period 1993-2013.

2015 ◽  
Vol 68 (7-8) ◽  
pp. 227-233
Author(s):  
Srdjan Djurdjevic ◽  
Sanja Stojanovic ◽  
Milos Pantelic ◽  
Dragan Nikolic ◽  
Marijana Basta-Nikolic ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Radical Hysterectomy ◽  
Invasive Cervical Cancer ◽  
International Federation ◽  
Stage I ◽  
Stage Ii ◽  
Gynecology And Obstetrics ◽  
Paraaortic Lymph Nodes ◽  
Novi Sad

Introduction. During the period from 1993 - 2013, 175 women with invasive cervical cancer underwent radical hysterectomy sec. Wertheim-Meigs at the Department of Gynecology and Obstetrics, Clinical Center of Vojvodina in Novi Sad. Indications for radical hysterectomy comprise histopathologically confirmed invasive cervical cancer in stages I B 1 - II B according to the International Federation of Gynecology and Obstetrics. Material and Methods. Stage of the disease or extent of the disease spread to the adjacent structures was assessed in accordance with the International Federation of Gynecology and Obstetrics staging system from 2009. Exclusion criteria were all other stages of this disease: I A and stages higher than II B, as well as the absence of definite histological confirmation of the cervical cancer (primary endometrial or vaginal cancer which infiltrates the uterine cervix). Prior the operation, the following had to be done: the imaging of pelvis and abdomen, chest X-ray in two directions, electrocardiography, internist and anesthesiological examination. Results. The patients? age ranged from 24-79 years (x : 46 years), and the operation duration was 120-300 minutes (x : 210 min.). Stage I B 1 was found in 64.6% of operated patients, 14.8% of the patients were in stage I B 2, 9.1% were in stage II A and 11.4 % were in stage II B. Blood loss during the operation ranged from 50-800 ml (on average 300 ml), and the number of removed lymph nodes per operation was 14-75 (x : 32). Intraoperative and postoperative complications developed in 6.8% of and 17.7% of patients, respectively. Recurrence was reported in 22 (12.5%) patients, most often in paraaortic lymph nodes (3.4%) and parametria (2.8%), while the overall 5-year survival rate was 87% until 2008. Concluision. Wertheim-Meigs radical hysterectomy is a basic surgical technique for the treatment of initial stages of invasive cervical cancer.

scholarly journals Impact of micrometastasis or isolated tumor cells on recurrence and survival in patients with early cervical cancer: SENTICOL Trial

2019 ◽  
Vol 29 (3) ◽  
pp. 447-452 ◽  
Author(s):  
Benedetta Guani ◽  
Maxence Dorez ◽  
Laurent Magaud ◽  
Annie Buenerd ◽  
Fabrice Lecuru ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Tumor Cells ◽  
Disease Free Survival ◽  
Isolated Tumor Cells ◽  
Free Survival ◽  
Gynecology And Obstetrics ◽  
Invasion Stage ◽  
Early Cervical Cancer ◽  
The Impact

ObjectivesThe aim of this study was to evaluate the impact of micrometastasis and isolated tumor cells on disease recurrence in patients with early-stage cervical cancer.MethodsWe included patients with International Federation of Gynecology and Obstetrics (FIGO) stage IA1 with lymphvascular space invasion, stage IA2, and IB1 who participated in the SENTICOL1 trial. A centralized histologic analysis with re-reading and ultrastaging was performed 3 months after surgery and treatment was not impacted by findings from our study. Patients were followed for 3 years and outcomes were compared according to prognostic factors.ResultsA total of 139 patients were included and 13 recurrences were found. There were two recurrences in patients with positive sentinel lymph node (SLN) (one macrometastases and one micrometastases) and 11 recurrences in patients with negative lymph nodes (sentinel or non-sentinel). Among patients with positive SLN for micrometastases there was only one recurrence. No patient with isolated tumor cells on their lymph nodes experienced a recurrence. There was a significant decrease in disease-free survival in patients aged >50 years (p = 0.01).ConclusionEvidence of micrometastasis or isolated tumor cells in the SLN of untreated patients with early cervical cancer in the SENTICOL1 trial did not impact progression-free survival.

Staging early cervical cancer in China: data from a multicenter collaborative

2019 ◽  
Vol 29 (5) ◽  
pp. 869-873 ◽  
Author(s):  
Weifeng Zhang ◽  
Chunlin Chen ◽  
Ping Liu ◽  
Weili Li ◽  
Min Hao ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Surgical Treatment ◽  
Neoadjuvant Treatment ◽  
Staging System ◽  
Clinical Staging ◽  
Tumor Diameter ◽  
Figo Staging ◽  
Gynecology And Obstetrics ◽  
Stage Ia ◽  
Early Cervical Cancer

BackgroundIn 2018 the International Federation of Gynecology and Obstetrics (FIGO) revised the staging system of cervical cancer. This study aimed to assess the quality of staging early cervical cancer in China before the revision.MethodsThis multicenter retrospective study included 34 tertiary hospitals in China. Medical records of patients with cervical cancer who underwent primary surgical treatment between January 2010 and December 2015 were reviewed retrospectively. All patients were clinically staged according to the 2009 FIGO staging system. Eligibility criteria included: histopathologically confirmed cervical cancer; 2009 FIGO stage IA–IIA2 based on 2009 FIGO staging system; primary surgical treatment including extrafascial, type II or type III radical hysterectomy; radical trachelectomy; with or without pelvic lymphadenectomy; regardless of surgical route via laparotomy or laparoscopy; and complete clinical and pathological data. Patients who received non-surgical treatment, neoadjuvant treatment, or those with incomplete data were excluded. The accuracy of clinical staging was assessed by comparison between clinical and pathologic stage using the latter as the reference standard.ResultsA total of 23 933 cases of cervical cancer were identified and 12 681 fulfilled the inclusion criteria. Of these patients, 69.6% were staged accurately, 9.4% were clinically understaged, and 21.0% were clinically overstaged. The accuracy of stage IA, IB1, IB2, IIA1, and IIA2 was 90.0%, 87.5%, 57.4%, 20.3%, and 25.5%, respectively. The causes of stage inaccuracy were as follows: vaginal involvement (62.3%), maximal tumor diameter (24.6%), extent of cervical stromal invasion (7.1%), parametrial invasion (5.8%), bladder or rectal infiltration (0.1%), and distant metastases (0.1%).ConclusionThe accuracy of staging early cervical cancer in China was suboptimal before the revision of the staging system, especially for IIA1 and IIA2. The most common reasons for staging inaccuracy were vaginal involvement and tumor diameter.

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