[Study of 68 microinvasive carcinomas of the cervix uteri]

The authors describe two types of micro-invasive carcinomas of the cervix: carcinomas in situ with early stromal invasion and carcinomas with definite micro-invasion. It is only if slices are taken every 250 microns through the cone that has been removed that a precise diagnosis of the lesion can be obtained and therefore treatment planned correctly for the illness. The following details are indispensable to decide what to do: the volume of the lesion in cubic mm, the depth of penetration in the chorion and the presence or absence of vascular and lymphatic invasion of the connective tissue of the cervix. Cytology is insufficient for accurate diagnosis and that is also true of directed colposcopy biopsies. This latter anyhow is not precise enough to evaluate what the treatment of the lesion should be. In the light of the observations that they have analysed and on reviewing the literature the authors have made a protocol for treatment. This is, for carcinoma in situ with early stromal invasion, conisation as long as the piece removed is entirely at the edges in healthy tissue is sufficient. In micro-invasive carcinomas of less than 500 cubic mm penetrating to a depth of less than 3 mm and without vascular or lymphatic invasion, total hysterectomy is the treatment of choice.(ABSTRACT TRUNCATED AT 250 WORDS)