The Diagnosis and Treatment in 46 Cases with Microinvasive Carcinoma of the Cervix Uteri

Kim, Jong Ryoul; Chung, Tae Bum; Kang, Jung Bae; Kim, Hong Bae; Lee, Keun Young; Sim, Jung Won; Kang, Sung Won

Abstract

OBJECTIVE
To review recurrence and prognosis of microivasive squamous cell carcinoma of the cervix that are associated with depth of invasion, pathologic finding and management(conservative or radical treatment) STUDY DESIGN: We conducted retrospective study in order to evaluate the results of therapeutic approaches in 46 patients with microinvasive cervical cancer from Jan 1987 to Oct 1996. RESULT: The mean age of patients was 44.6+ 8.86 years. Only one woman was nullipara, and the mean parity was 2.8, Overall diagnostic accuracy of pap smear and punch biopsy were 54.3% and 79.4%. As the depth of invasion was deeper, the diagnostic accuracy of punch biopsy increased(p<0.05), The confluence pattern and lymphovascular space involvement were observed in 39.1% and 4.9%. The confluence pattern was observed with statistical significant in advanced depth of stromal invasion. In the surgical management, vaginal hysterectomy was done in 28 patients, conization(l patient), total abdominal hysterectomy(8 patients) and radical hysterectomy with pelvic lymph node dissection(9 patients) was done, no positive node was in 104 pelvic lymph node dissected. Though all cone margin was free and all endocervical curettage was negative, residual lesion(2 patients) was present in the hysterectomy after conization, The median follow-up period was 64 months. There was no recurrence in all cases and 5 years survival rate was 100%
CONCLUSION
We suggest that microinvasive carcinoma of the cervix may be the disease of good prognosis and no recurrence, and less radical therapy for the patients with microinvasive carcinoma may be sufficient.