CONSERVATIVE THERAPY FOR MICROINVASIVE CARCINOMA OF THE UTERINE CERVIX

The purpose of this study was to evaluate conservative therapy for microinvasive carcinoma (MIC) of the cervix. Large contact Nd-YAG laser conization (laser cone) with contact vaporization using contact probes was performed on 90 cases of MIC and 21 cases of early invasive carcinoma (early IC), with long-term postoperative follow-up for patients at Osaka Medical College, Osaka, Japan. The cure rates of MIC and early IC were 96.7 and 80.9%, respectively. The rates of incomplete excision and true residuation in cases with MIC were 17.8 and 10.0% and those in cases with early IC were 76.2 and 19.0%. Therefore, the spontaneous cure rate following incomplete excision of MIC and early IC was 43.7 and 75.0%. Hysterectomy was performed, for various indications, after cone in 5 patients (5.6%) with MIC, none of the patients with IC of less than 3 mm, 2 (22.2%) of the patients with IC of 3.1 to 5 mm, and 7 patients (87.5%) whose IC was 5.1 mm or more in depth. Combining the data from our department and those in the literature collected an incidence of lymph node metastasis of 0.15% for MIC and of 1.13% for IC of less than 5 mm. In conclusion, conservative therapy is indicated for MIC, and the contact laser cone with contact vaporization is considered to be an excellent therapeutic conservative method. (C) 1994 Academic Press, Inc.