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KMID : 0358419960390050938
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Korean Journal of Obstetrics and Gynecology
1996 Volume.39 No. 5 p.938 ~ p.945
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Microinvasive Cervical Carcinoma: Clinicopathologic Analysis
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Abstract
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The diagnosis and management of microinvasive cervical cancer remains a controversial subject. Most authorities define microinvasion by depth of penetration by cancer cells of less than an arbitrarily and subjectively determined 1 or 3 or 5 or
more
millimeters beneath the basement membrane. Recently, the International Federation of Obstetrics and Gynecology(FIGO) has developed a new cervical cancer staging. We used the definition as stromal invasion of cancer cell with maximum depth of 3 mm
and no
wider than 7 mm from the base of the epithelium.
We conducted this retrospective study in order to evaluate the results of therapeutic approaches in patients with microinvasive cervical cancer. We have experienced 55 cases with microinvasive cervical cancer from November 1987 to May 1995. The
age
of
the study subjects ranged from 39 to 71 years with a median of 39 years. Pregnancy was never experienced in 2 cases(36%) and the mean parity was 2.7. The most frequent complaint was postcoital bleeding which was shown I 20 cases(32.1%), whereas
most
cases were revealed incidentally through the routine Pap smear. The corresponding rate of Pap smear to histologic diagnosis was approximately 36.4%. However, corresponding rate within on histologic grade was about 92.8%. As to the reports of
colposcopically directed biopsy, 72.7% of cases showed microinvasion. Type I extended hysterectomy was performed in 26 cases and type II extended hysterectomy was done in 7 cases with less than 1mm invasion and 19 cases with greater than 1 mm and
no
greater than 3 mm stromal invasion. There was no surgery-related deaths in this series and 5 year survival was 100%.
In conclusion, we suggest that less radical therapeutic approach for the patients with no grater 3 mm stromal invasion may be beneficial. But further prospective study based on larger numbers of cases with multi-institutional cooperation and
designed
protocol will be necessary.
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KEYWORD
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