Microinvasive carcinoma of the cervix

Abstract

BoT H THE definition and the management of microinvasive carcinoma of the cervix remain controversial. Part of the controversy stems from confusion of terms and a lack of detail in description of the lesion. The crux of the problem is defining the point in the evolution of this disease from intraepithelial to invasive carcinoma at which the lesion changes its biologic behavior and becomes capable of lymphatic spread and metastasis. Once this point is defined, an intelligent approach to management can be made. I refer to conservative or radical procedures tailored to fit the lesion. Many terms have been used interchangeably in describing microinvasive carcinoma2*l 23. . microcarcinoma, 11, 58* 6o covert invasive carcinoma,54 incipient invasion,63 early invasive carcinoma,37l 68 microscopic foci of stromal invasion,18 very small carcinoma,21s 2T superficial invasion, 131 *O minimal invasion,21 intraepithelial carcinoma with microinvasive foci,“6 early invasive preclinical carcinoma,66 and clinical Stage IA.68 The need for standardization of nomenclature is obvious. Definitions also vary considerably.lO* I47 lG* 2of 33* 42p 58* 62, 63p 65 The definition agreed upon by the Committee on Gynecologic Pathology