[Microinvasive carcinoma of the uterine cervix. Risk factors and therapeutic options]

Aim of this study was to analyze the staging of disease according to correlation between depth of stromal invasion, lymph vascular space involvement, nodal metastases and recurrence and mortality rates in uterine cervical carcinoma. Data of 16 different surveys from 1980 to 1996 inclusive were collected through a Medline research; papers were selected according to available information about depth of invasion, lymph vascular invasion, nodal metastases, recurrence and mortality rate. Results of these surveys were pooled with the following aims: 1 correlation between depth of invasion and nodal metastases occurrence; 2 evolution of prognostic value of lymph vascular invasion; 3 best management according to biology of disease. Depth of stromal invasion seems to be the most important prognostic factor in early cervical cancer, with a critical cut-off of 3 mm of depth. Lymph vascular invasion correlates both with nodal metastases and with prognosis, which strictly depends only on depth of invasion; as a consequence, lymph vascular invasion would not represent an independent prognostic factor. Finally radical treatment (i.e. more aggressive therapies) does not add any curative advantage when compared with conservative treatment, which must be currently considered standard in stage IA cervical cancer.