TNM T1a宫颈癌患者预后良好；然而，复发风险仍然是一个令人担忧的问题，管理指南基于有限的数据。在这里，我们对宫颈癌监测 (SCCAN) 联盟进行了亚组分析，目的是确定 T1a 宫颈癌患者的预后。SCCAN 是一项国际、多中心、回顾性队列研究，研究对象为在三级中心接受手术治疗的宫颈癌患者。纳入标准包括：2007年至2016年间接受过组织学证实的宫颈癌； TNM T1a；初级手术治疗；以及至少 1 年的后续数据可用性。排除标准包括主要放化疗治疗以及缺失治疗相关或临床数据。在纳入的 975 名患者中，554 名 (57%) 为 T1a1 患者，421 名 (43%) 为 T1a2 患者。大多数人患有鳞状细胞癌（78%）。 79 名患者 (8.1%) 患有淋巴管间隙侵犯 (LVSI)。 455 名患者 (47%) 接受了根治性子宫切除术/宫旁切除术。分别有 401 名 (41%) 和 361 名 (37%) 患者接受了腹腔镜手术和开放手术。 56 名患者 (5.7%) 接受了辅助治疗。对 524 名患者 (54%) 进行了淋巴结 (LN) 评估，其中 15 名患者 (2.9%) 发现淋巴结受累。有 40 例 (4.1%) 复发，平均发生时间为 26 个月 (4-106)，其中 33 例 (82.5%) 发生在骨盆。在 T1a1 病例中，如果 LVSI 阴性，则有 10 例复发 (2.0%)；如果 LVSI 阳性，则有 3 例复发 (6.7%)。在 T1a2 病例中，如果 LVSI 阴性，则有 23 例复发 (6.7%)；如果 LVSI 阳性，则有 4 例复发 (5.1%)。 LN 组中有 3 例复发（复发率为 20%）。T1a 宫颈癌的复发风险为 4.1%，与最近发表的前瞻性试验中 Figo 1B 癌症患者的复发风险相对应。淋巴结受累是疾病复发的危险因素。我们的研究结果表明，T1a期宫颈癌，除了T1a1 LVSI阴性疾病外，应遵循与FIGO 1B期癌症相同的治疗原则。版权所有©2024。由Elsevier Inc.出版。

Patients with TNM T1a cervical cancer have excellent prognosis; however, the risk for recurrence remains an issue of concern and management guidelines are based on limited data. Here we performed subgroup analysis of the Surveillance in Cervical Cancer (SCCAN) consortium with the objective of defining the prognosis of T1a cervical cancer patients.SCCAN was an international, multicentric, retrospective cohort study of patients with cervical cancer undergoing surgical treatment in tertiary centers. Inclusion criteria included: histologically confirmed cervical cancer treated between 2007 and 2016; TNM T1a; primary surgical management; and at least 1-year of follow-up data availability. Exclusion criteria included treatment with primary chemo-radiation, and missing treatment-related or clinical data.Out of 975 patients included, 554 (57 %) were T1a1 and 421 (43 %) T1a2. The majority had squamous-cell carcinoma (78 %). 79 patients (8.1 %) had lymphovascular space invasion (LVSI). 455 patients (47 %) underwent radical hysterectomy/ parametrectomy. Laparoscopic and open surgery was performed in 401 (41 %) and in 361 (37 %) patients, respectively. Adjuvant treatment was administered to 56 patients (5.7 %). Assessment of lymph nodes (LN) was performed in 524 patients (54 %), with LN involvement found in 15 (2.9 %). There were 40 (4.1 %) recurrences, occurring at a median of 26 months (4-106), out of which 33 (82.5 %) occurred in pelvis. Among T1a1 cases, there were 10 recurrences (2.0 %) if LVSI was negative, and 3 recurrences (6.7 %) if LVSI was positive. Among T1a2 cases, there were 23 recurrences (6.7 %) if LVSI was negative, and 4 recurrences (5.1 %) if LVSI was positive. There were 3 recurrences in the LN+ group (recurrence rate 20 %).The risk of recurrence in T1a cervical cancer was 4.1 % corresponding to the rates seen in patients with FIGO 1B cancer in recently published prospective trials. LN involvement represents a risk factor for disease recurrence. Our results indicate that stage T1a cervical cancer, apart from T1a1 LVSI negative disease, should follow the same principles in the management as that of FIGO stage 1B cancer.Copyright © 2024. Published by Elsevier Inc.