6
Treatment
Table 3. Recommendations for Stage IA, IB, and IIA Disease
Type of Disease Basic Limited
IA1, LVSI negative,
FS (see Discussion in
full text Guideline)
1A1 (negative margins):
cone biopsy
a
(with scalpel)
Repeat cone biopsy or
extrafascial hysterectomy
for positive margins
(EB, H, S)
1A1 (negative margins): cone
biopsy
Repeat cone biopsy or
extrafascial hysterectomy for
positive margins
(EB, L, W)
IA1, LVSI positive,
FS
Cone biopsy in selected
cases, if follow-up possible
(CB, I, W)
Cone biopsy
(CB, I, W)
IA1, non-FS (no
LVSI)
Cone biopsy (if follow-up
possible) OR extrafascial
hysterectomy,
b
then
observe aer initial cone
biopsy, repeat cone, or
extrafascial hysterectomy if
margins are positive
(EB/CB, H, S)
Cone biopsy (if follow-up
possible); observe (aer cone
biopsy
c
) OR extrafascial
hysterectomy
b
(extrafascial
hysterectomy OR modified
radical hysterectomy plus
PLND OR if positive margins
repeat conization
d
)
(EB/CB, H, S)
IA1, non-FS (with
LVSI)
As above
(CB, L, W)
Stage IA1 (with LVSI) and
stage IA2: modified radical
hysterectomy
(CB, L, W)
IA2, FS Cone biopsy (if follow-up
possible)
(CB, L, W)
Cone biopsy (if follow-up
possible)
(CB, L, W)
IA2, non-FS Cone biopsy (if follow-up
possible) or extrafascial
hysterectomy (non-FS)
(CB/EB, L, W)
Extrafascial hysterectomy
(EB, L, W)
Cone biopsy plus PLND ±
para-aortic LN sampling
c
(EB, L, W)
Modified radical hysterectomy
plus PLND ± para-aortic LN
sampling
d
(EB, I, M)
