Carcinoma In Situ Skip Lesions of the Uterine Corpus in Cervical Squamous Cell Carcinoma: Impact on Target Setting in Radiotherapy
- 1Department of Radiation Oncology Yamagata University Faculty of Medicine Yamagata Yamagata Japan
- 2Department of Pathology Yamagata University Faculty of Medicine Yamagata Yamagata Japan
Abstract
Background: In definitive radiotherapy for FIGO Stage I–III cervical cancer, external beam radiotherapy and/or brachytherapy are used—alone or in combination with concurrent chemotherapy depending on stage—with target delineation largely guided by clinically apparent disease. However, discontinuous carcinoma in situ (CIS) “skip lesions” within the uterine corpus are well described in cervical adenocarcinoma, whereas their presence in cervical squamous cell carcinoma (SCC) has not been systematically evaluated.
Aims: This study aimed to investigate the presence or absence of CIS skip lesions in the uterine corpus of patients with cervical SCC.
Methods and Results: This retrospective study included all patients who underwent total or radical hysterectomy for cervical SCC at Yamagata University Hospital between January 2013 and April 2020. Patients who underwent prior radiotherapy or preoperative chemotherapy, or had non‐squamous histological components, were excluded. Fifty patients were enrolled. Pathological examination of serially sectioned uterine specimens was conducted to identify skip lesions, defined as discontinuous CIS lesions in the uterine corpus, as confirmed by a pathologist and a radiation oncologist. Pathological evaluation showed that 29 patients (58%) had FIGO Stage I disease, 6 patients (12%) had FIGO Stage II disease, and 15 patients (30%) were classified as FIGO Stage IIIC1. Preoperative imaging studies did not identify any skip lesions in the uterine corpus. However, one patient (2%; Clopper–Pearson 95% confidence intervals: 0.05%–10.5%) presented with a histologically confirmed CIS skip lesion located in the uterine corpus, approximately 2 cm cranial to the primary tumor margin, that was undetectable on imaging. The primary tumor after biopsy measured 3 mm and was diagnosed as non‐keratinizing SCC without > 1/3 stromal invasion. Lymphovascular space invasion, parametrial invasion, and corpus invasion were not observed.
Conclusion: Although rare, CIS skip lesions in the uterine corpus can occur in patients with cervical SCC.
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BibTeX
@article{harada2026carcinoma,
title = {{Carcinoma In Situ Skip Lesions of the Uterine Corpus in Cervical Squamous Cell Carcinoma: Impact on Target Setting in Radiotherapy}},
author = {Mayumi Harada and Yasuhito Hagiwara and Takanobu Kabasawa and Hiraku Sato and Mayumi Ichikawa and Hiroko Akamatsu and Takashi Kaneko and Natsuko Yano and Ken Uematsu and Masanori Komatsu and Taiyo Tanae and Kenji Nemoto and Masashi Koto},
journal = {Cancer Reports},
year = {2026},
month = nov,
doi = {10.1002/cnr2.70751},
url = {https://doi.org/10.1002/cnr2.70751},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Carcinoma In Situ Skip Lesions of the Uterine Corpus in Cervical Squamous Cell Carcinoma: Impact on Target Setting in Radiotherapy
AU - Mayumi Harada
AU - Yasuhito Hagiwara
AU - Takanobu Kabasawa
AU - Hiraku Sato
AU - Mayumi Ichikawa
AU - Hiroko Akamatsu
AU - Takashi Kaneko
AU - Natsuko Yano
AU - Ken Uematsu
AU - Masanori Komatsu
AU - Taiyo Tanae
AU - Kenji Nemoto
AU - Masashi Koto
PY - 2026
DA - 2026/11/05
JO - Cancer Reports
DO - 10.1002/cnr2.70751
UR - https://doi.org/10.1002/cnr2.70751
AB - Background: In definitive radiotherapy for FIGO Stage I–III cervical cancer, external beam radiotherapy and/or brachytherapy are used—alone or in combination with concurrent chemotherapy depending on stage—with target delineation largely guided by clinically apparent disease. However, discontinuous carcinoma in situ (CIS) “skip lesions” within the uterine corpus are well described in cervical adenocarcinoma, whereas their presence in cervical squamous cell carcinoma (SCC) has not been systematically evaluated. Aims: This study aimed to investigate the presence or absence of CIS skip lesions in the uterine corpus of patients with cervical SCC. Methods and Results: This retrospective study included all patients who underwent total or radical hysterectomy for cervical SCC at Yamagata University Hospital between January 2013 and April 2020. Patients who underwent prior radiotherapy or preoperative chemotherapy, or had non‐squamous histological components, were excluded. Fifty patients were enrolled. Pathological examination of serially sectioned uterine specimens was conducted to identify skip lesions, defined as discontinuous CIS lesions in the uterine corpus, as confirmed by a pathologist and a radiation oncologist. Pathological evaluation showed that 29 patients (58%) had FIGO Stage I disease, 6 patients (12%) had FIGO Stage II disease, and 15 patients (30%) were classified as FIGO Stage IIIC1. Preoperative imaging studies did not identify any skip lesions in the uterine corpus. However, one patient (2%; Clopper–Pearson 95% confidence intervals: 0.05%–10.5%) presented with a histologically confirmed CIS skip lesion located in the uterine corpus, approximately 2 cm cranial to the primary tumor margin, that was undetectable on imaging. The primary tumor after biopsy measured 3 mm and was diagnosed as non‐keratinizing SCC without > 1/3 stromal invasion. Lymphovascular space invasion, parametrial invasion, and corpus invasion were not observed. Conclusion: Although rare, CIS skip lesions in the uterine corpus can occur in patients with cervical SCC.
SN - 2573-8348
ER -