Microinvasive squamous cell carcinoma of the cervix is a subject assoicated with decades of confusion, multiplicity of definitions, and a variety of therapeutic approaches. The diversity of therapeutic approaches to microinvasive cervical
carcinoma
reflects uneasiness in reconciling two aspects of the disease: The morbidity associated with radical therapeutic measures must be weighed against the probability of lymph node metastasis, recurrence, and death from cancer, So in this study, we
adress
these issuses by reviewing our 10 years experinece from Fed. 1982, to Fed 1992. We evaluated 59 cases of patient histologically proven by microinvasive carcinoma of the cervix and treated by operation including total abdominal hysterectomy,
modified
radical and radical hysterectomy with pelvic lymph node dissection.
We use the definition as stromal penetration by carcinoma not exceeding a depth of 3mm from the surface at the point of origin. The mean age of patients was 42.0 years old at the time of diagnosis. The sensitivity of diagnosis by pap smear was
84.7% but
there was no relationship between pap smear and depth of invasion. The sensitivity of punch biopsy was statistically higher in deeper invasion. Depth of invasion was 1mm or less in 15 patients, 1.1-2.0mm in 19 patients, and 2.1-3.0mm in 25
patients.
There was no lymph vascular space invasion. The inflammation was more severe and the pattern of invasion was more confluent with deeper invasion. Pelvic lymph node dissection was done in 48 patients and there was no lymph node metastasis.
Total abdominal hysterectomy was done in 15 cases of microinvasive cervix cancer patient, and 19 cases of patient were treated by total abdominal hysterectomy with pelvic lymph node dissection and 35 cases were treated by radical hysterectomy
with
pelvic lymph node dissection. And currently less radical theapeutic approaches has been used with the colposcopy. There was no recurrence in all cases and 5 year survival rate was 100%.
so these data suggest that less radical therapy for these disease may be sufficient if the depth of invasion is less than 3mm.
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