Management of Superficially Invasive Carcinoma of the Cervix* *This chapter is dedicated to the memory of our friend and colleague Professor Andrew Östör, who died in January 2003, in recognition of his contribution to our knowledge of microinvasive cancer of the cervix and particularly its conservative management. This was his life's work, and countless women are the beneficiaries of his legacy.
The objective of this study was to determine whether the depth of invasion was related to lymph vascular space invasion (LVSI) and lymph node metastasis and whether there was a correlation between LVSI and lymph node metastasis in stage IA cervical cancer. The medical records, including surgical notes and pathologic reports, of 202 patients with microinvasive squamous cell carcinoma of the uterine cervix were reviewed retrospectively. There was a positive correlation between the depth of invasion and the LVSI, and the incidence of lymph node metastasis was slightly higher than those reported hitherto for stage IA1 cervical cancer, especially in the depth of invasion of 1-3 mm group. However, among four patients with lymph node metastasis, only two patients had positive LVSI. There was no definite correlation between LVSI and lymph node metastasis. LVSI could not identify the patients with high risk for lymph node metastasis.
The objective of this study was to determine whether the depth of invasion was related to lymph vascular space invasion (LVSI) and lymph node metastasis and whether there was a correlation between LVSI and lymph node metastasis in stage IA cervical cancer. The medical records, including surgical notes and pathologic reports, of 202 patients with microinvasive squamous cell carcinoma of the uterine cervix were reviewed retrospectively. There was a positive correlation between the depth of invasion and the LVSI, and the incidence of lymph node metastasis was slightly higher than those reported hitherto for stage IA1 cervical cancer, especially in the depth of invasion of 1-3 mm group. However, among four patients with lymph node metastasis, only two patients had positive LVSI. There was no definite correlation between LVSI and lymph node metastasis. LVSI could not identify the patients with high risk for lymph node metastasis.
Microinvasion of cervical cancer was defined according to the International Federation of Gynecologists and Obstetricians classification as a depth of invasion of no greater than 3 mm and a horizontal dimension of no greater than 7 mm. Although the status of the lymph nodes is not included in the staging of cervical cancer, the presence or absence of lymph node metastasis provides important prognostic information and influences decision-making for treatment. For patient with stage IA1 microinvasive squamous cell carcinoma, the incidence of lymph node involvement is estimated to be 1%, but very little is known about lymph node metastasis in microinvasive adenocarcinoma of cervical cancer. We have experienced a case of pelvic lymph node metastasis in microinvasive adenocarcinoma of cervix with a depth of invasion of 3 mm or less, with no lymphovascular invasion. So, we report the case with brief review of literatures.
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