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Relation of Histologic Factors to the Response of Stage I Epidermoid Carcinoma of the Cervix to Surgical Treatment

Analysis of 115 Patients

From the Department of Pathology and the Gynecology Service, Memorial Hospital for Cancer and Allied Diseases, New York, NY.

Abstract

An evaluation of histologic factors in 115 patients with carcinoma of the uterine cervix, Stage I, treated by radical hysterectomy and extirpation of pelvic lymph nodes disclosed that patients 45 or younger did poorly; the frequency of lymph node metastases and the mortality were greater than in the older group; the difference was statistically significant. Stromal invasion of greater depth than 5 mm, lymph node metastases, and parametrial involvement were factors of ominous prognostic significance. Well differentiated carcinomas (Grade I) had the highest rate of lymph node metastases and generally did poorly. Undifferentiated carcinomas (Grade III) had a low incidence of lymph node metastases and did very well. It is suggested that radiotherapy should be the primary choice for Grade I cancers and surgical treatment for Grade III ones. Either mode of therapy appears equally successful with Grade II cancers. A dense lymphocytic infiltrate accompanying Grade II and III cancers appears to have a favorable influence on the outcome of treatment.