[Adequate treatment of micro-invasive carcinoma of the uterine cervix (author's transl)].

At the University Department in Heidelberg 58 micro-invasive carcinomas of the uterine cervix were found between 1965 and 1974. 8 cases were diagnosed in other institutions by directed biopsies. Three cases were detected during the microscopic examination of uteri removed for emergency indications and three cases were detected after hysterectomy for cytological findings indicative of carcinoma in situ of the uterine cervix. In 44 cases an optimal conization of the cervix was carried out. Microscopic examination of these cases showed early stromal invasion in 33 cases. In 6 cases a newtork infiltration was found und in 5 cases a plump infiltration was found. The incidence of radical Wertheim operations of 21 in this group is explained by cases in this group who had inadequate diagnosis prior to admission. In 8 cases the indication for the Wertheim radical hysterectomy was a carcinomatous lymphangiosis in the conization specimen. In none of these cases metastatic tumor was found in the lymph nodes although 13 to 44 lymph nodes were examined per case. In accordance with the newer literature it is recommended to limit treatment of micro-invasive changes of the uterine cervix to routine hysterectomy or to optimal conization of the cervix if certain prerequisites are met. The results of the follow-up examinations of the reported cases appear to justify this recommendation.