One hundred and eleven patients with microinvasive carcinoma of the uterine cervix were studied over a 21-year period. Thirty-five cases of carcinoma in situ with questionable stromal invasion were excluded. Cases with pathologic examination of less than a cervical cone or the entire cervix were not accepted. The sole pathologic criterion for inclusion was unequivocal invasion to a depth of no more than 5.0 mm. Ninety-one patients were followed for 5 years or until death, and 80 patients for 10 years or until death. One patient was lost to follow-up at 5.5 years. The two deaths officially attributed to cervix cancer prior to 10 years were signed out by nonphysician assistant coroners. Available clinical evidence indicates that at least one of these patients, and probably both, did not die of cervix cancer. From these data, simple hysterectomy would seem to be the maximal treatment indicated. Since the prognosis of microinvasive carcinoma is similar to that of carcinoma in situ, it is suggested that such cases not be included when considering the end results of Stage I cervix cancer.
Cancer 38:629-632. 1976.
EANINGFUL MANAGEMENT DECISIONS FOR
M cancer must be based on the known behavior of explicitly defined lesions. Microinvasive carcinoma of the uterine cervix has been defined and redefined, and the definitions have been modified many times. There also still exist wide differences of opinion as to the optimal management. hlost studies designed to clarify the problem have been concerned with the likelihood of lymph node spread. Lymph node involvement has been found to be absent or, at best, infrequent. 1,5*6,7 An alternative approach to the problem would be to study the end results obtained from the various modalities selected for the treatment of a significant number of cases. Since lymph node dissection was rarely done in the material from our registry, we chose the alternative of analyzing end results.
The second aspect of microinvasive carcinoma that needs further consideration is the staging of these lesions. T h e International Federation of Gynecology and Obstetrics, the American Joint