Microinvasive Carcinoma of the Cervix

Abstract

Superficially invasive cervical carcinomas only infrequently metastasize to regional lymph nodes or recur. A category of superficially invasive carcinoma termed microinvasive carcinoma has been defined, based on clinicopathologic studies of large numbers of superficially invasive squamous cell carcinomas. A microinvasive carcinoma is one that invades to a depth of 3 mm or less, does not invade lymphovascular spaces, and shows 7 mm or less of horizontal spread. Microinvasive squamous cell carcinoma has such a low risk of metastasis or recurrence, 1% or less, that it can be treated conservatively by a cone biopsy with adequate free margins or with a simple hysterectomy, while more deeply invasive carcinomas are often treated by more radical methods. The category of microinvasive carcinoma is widely accepted for squamous cell carcinomas. It is less accepted for adenocarcinomas because fewer cases have been studied, but the studies that have been reported thus far suggest that microinvasive adenocarcinoma may also be amenable to conservative treatment.

Carcinomas of the Uterine Cervix: Comprehensive Review With An Update on Pathogenesis, Nomenclature of Precursor and Invasive Lesions, and Differential Diagnostic Considerations

“…The Society of Gynecologic Oncology defines microinvasion as a stromal invasion of ≤ 3 mm in the absence of lymphovascular invasion; whereas the definition used in the University of California is stromal invasion ≤ 3 mm, horizontal spread ≤ 7 mm, the lack of lymphovascular invasion and margins free of dysplasia and carcinoma. 41 The significance of microinvasive carcinomas lies in the fact that multiple studies have shown an excellent prognosis, a lack of lymph node metastasis, and a very low risk of recurrence. 42 Original studies were performed on SCC, where the category of microinvasive carcinoma is widely accepted.…”

“…There has been a considerable debate on the exact definition of microinvasive carcinoma. The Society of Gynecologic Oncology defines microinvasion as a stromal invasion of ≤3 mm in the absence of lymphovascular invasion; whereas the definition used in the University of California is stromal invasion ≤3 mm, horizontal spread ≤7 mm, the lack of lymphovascular invasion and margins free of dysplasia and carcinoma 41…”