MICROINVASIVE CARCINOMA OF THE CERVIX - RATIONALE FOR CONSERVATIVE TREATMENT IN EARLY SQUAMOUS-CELL CARCINOMA

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.