Uterine Cervix                                                                
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Uterine Cervix - Cone/LEEP (SUTC)


- Recommended but not required for cold knife cone or LEEP excisions with primary invasive carcinoma or carcinosarcoma of the cervix

Specimen and Surgical Procedure

Specimen, procedure................................................................... 


Tumor

Tumor size.................................................................................. __ cm

Histologic type.............................................................................

Histologic grade...........................................................................

Stromal invasion (provide measurements OR state "depth/extent cannot be determined")

               Depth (in mm)*................................................................. __ mm

               Horizontal extent longitudinal/length (in mm)........................ __ mm

               Horizontal extent circumferential/width* (in mm)..................... __ mm

Lymphovascular invasion.............................................................. not identified/present

Final Margins

Endocervical margin

                       Invasive carcinoma at margin........................ uninvolved/involved (specify location)

                       Intraepithelial neoplasia at margin..................uninvolved/involved by high-grade squamous intraepithelial lesion (CIN 2-3)/involved by adenocarcinoma in situ

Ectocervical margin

                       Invasive carcinoma at margin........................ uninvolved/involved (specify location)

                       Intraepithelial neoplasia at margin..................uninvolved/involved by high-grade squamous intraepithelial lesion (CIN 2-3)/involved by adenocarcinoma in situ

Deep margin

                       Invasive carcinoma at margin........................ uninvolved/involved (specify location)

                       Intraepithelial neoplasia at margin..................uninvolved/involved by high-grade squamous intraepithelial lesion (CIN 2-3)/involved by adenocarcinoma in situ



Uterine Cervix - Hysterectomy (SUTCH)

- For hysterectomy, trachelectomy, or pelvic exenteration with primary invasive carcinoma or carcinosarcoma of the cervix

Specimen and Surgical Procedure

Specimen, procedure...................................................................

Lymph nodes submitted and/or identified in the specimen................ yes/no

Tumor

Tumor size…............................................................................... __ cm

Histologic type.............................................................................

Histologic grade...........................................................................

Stromal invasion (provide measurements OR state "depth/extent cannot be determined")

               Depth (in mm)*................................................................. __ mm

               Horizontal extent longitudinal/length (in mm)........................ __ mm

               Horizontal extent circumferential/width* (in mm)..................... __ mm

Other tissue/organ involvement.....................................................

Lymphovascular invasion.............................................................. not identified/present

Final Margins

Ectocervical margin

                       Invasive carcinoma at margin........................ uninvolved/involved (specify location)

                       Intraepithelial neoplasia at margin..................uninvolved/involved by high-grade squamous intraepithelial lesion (CIN 2-3)/involved by adenocarcinoma in situ

Radial (circumferential) margin

                       Invasive carcinoma at margin........................ uninvolved/involved (specify location)

Lymph Nodes** (required only if lymph nodes are present in specimen)

Total number of nodes examined (sentinel and non-sentinel): _____

Specify Site(s)#: ____________________________

# Note: Information should include location and laterality of lymph nodes examined.

Number of sentinel nodes examined: _____

Specify lymph node(s) with tumor#: ____________________________

# Note: Information should include location and laterality of lymph nodes with tumor.

Number of nodes with metastasis (excludes ITCs): _____

Number of nodes with isolated tumor cells (ITCs) (0.2 mm or less): _____ 

Pathologic stage (AJCC 8th ed.).................................................. pT__N__M__


Gynecologic


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