Conservative Surgery in Treating Patients with Low-Risk Stage IA2 or IB1 Cervical Cancer

Inclusion Criteria

• Histologically confirmed squamous cell carcinoma of the cervix (any grade) or histologically confirmed grade 1 or 2 adenocarcinoma of cervix
• International Federation of Gynecology and Obstetrics (FIGO) stage IA2 or IB1 disease
• Tumor diameter =< 2 cm on physical exam and on imaging studies
• No lymphovascular space invasion (LVSI) present on biopsy or previous cone
• Less than 10 mm of cervical stromal invasion
• Cone margins and endocervical curettage (ECC) specimen negative for invasive cancer, cervical intraepithelial neoplasia (CIN) II, CIN III or adenocarcinoma-in-situ; (a negative margin is defined as no invasive cancer within 1.0 mm of both the endocervical and ectocervical margins and no adenocarcinoma in situ [AIS] or CIN II or CIN III at the inked or cauterized margin; one repeat cone and ECC permitted)
• Patients are eligible for the study when a cone and ECC are performed prior to pre-enrollment in the study, and pathologic eligibility criteria are met; the cone and ECC must be performed within 12 weeks prior to pre-enrollment in the study; if the cone and ECC performed prior to pre-enrollment do not meet the pathologic criteria, patients may be pre-enrolled and are allowed 1 repeat cone & ECC after pre-enrollment in order to meet pathologic eligibility criteria
• Patients must sign an approved informed consent document
• If patient is of childbearing potential, she must have a negative blood or urine pregnancy test within 14 days of surgical treatment on study
• Imaging with positron emission tomography (PET) scan, computed tomography (CT) scan of the abdomen and pelvis, and/or magnetic resonance imaging (MRI) of the abdomen and pelvis must be performed and negative for metastatic disease within 12 weeks of enrollment

Exclusion Criteria

• Clear cell, neuroendocrine, adenosquamous, serous carcinoma or other high-risk histologies
• Grade 3 adenocarcinoma
• FIGO stage IA1, IB2, II, III or IV disease
• Tumors > 2 cm in diameter on physical exam or imaging studies
• Presence of LVSI
• Greater than or equal to 10 mm of cervical stromal invasion
• Cone margins or ECC specimen positive for invasive cancer, CIN II, CIN III or adenocarcinoma-in-situ (one repeat cone permitted)
• Neoadjuvant radiation therapy or chemotherapy for cervical cancer
• Patients unwilling or unable to provide informed consent for the study
• Evidence of metastatic disease on PET, CT, and/or MRI performed within 12 weeks of enrollment
• Patients who have had a simple hysterectomy (cut through hysterectomy)