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Microinvasive Carcinoma of the Cervix

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.