Lymph node metastasis in microinvasive epidermoid cancer of the cervix

A retrospective series of 69 patients indicates that the definition of a diagnosis of microinvasive cancer of the cervix should indicate a lack of blood vessel or lymphatic permeation as well as invasion of not more than 3 mm below the basement membrane. The incidence of lymph node metastases in this group of patients in whom microinvasive cancer of the cervix had been diagnosed was 7.1%. Two of the 4 patients with positive lymph nodes demonstrated lymphatic or blood vessel permeation on preoperative conization and 2 did not, an incidence of 3.6%. One patient had lymphatic invasion on conization with negative lymph nodes on final surgical specimen. Two patients had recurrent epidermoid carcinoma within less than 10 years and died of recurrent carcinoma. Maximum survival can only be achieved by full treatment of Stage IA lesions. Since surgical mortality was absent in our series, surgical extirpation by extensive (radical) hysterectomy and bilateral lymphadenectomy should give optimum results.