F. Lecuru et al., MICROINVASIVE CARCINOMA OF THE CERVIX - RATIONALE FOR CONSERVATIVE TREATMENT IN EARLY SQUAMOUS-CELL CARCINOMA, European journal of gynaecological oncology, 18(6), 1997, pp. 465-470
Numerous definitions of microinvasive carcinoma (MIC) have been propos
ed. Taking into account that a classification must be a guide for the
evaluation of prognosis and treatment, the authors revealed the risk o
f spread in MIC. Two major prognostic factors can be identified in the
literature: the volume of the lesion and the presence of capillary-li
ke space involvement (LVI). The former item is generally assessed by t
he depth of invasion. Two kinds of MIC can be distinguished. Those wit
h stromal invasion under 3 mm and without LVI, and those with invasion
over 3.1 mm depth or LVI. The former have little risk of parametrial
and nodal involvement and a high rate of survival. The latter have a g
reater risk of spread beyond the cervix and many authors now consider
them as true invasive cancers. The Society of Gynaecologic Oncologists
(SGO) definition seems more reliable. For lesions invading the stroma
within 3 mm, treatment can be limited to a standard hysterectomy with
good results. Some authors have proposed more conservative therapy su
ch as conization. This procedure could be desirable for young women wh
o want to preserve their anatomical integrity, fertility and sexual fu
nction. In selected cases, short term results are similar to those of
hysterectomy but there is a lack of controlled studies with long term
follow-up.