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Vascular Invasion as a Prognostic Factor in Stage IB Cancer of the Cervix

From the Departments of Obstetrics and Gynecology at Lenox Hill Hospital and Memorial Hospital and Cornell Medical College, the Department of Laboratories at Lenox Hill Hospital, and the Departments of Pathology at Columbia College of Physicians and Surgeons and Lenox Hill Hospital, New York, New York

Abstract

One hundred ninety-one cases or histopathologically confirmed invasive carcinoma of the cervix were available to study. Until early diagnosis is made routinely and treatment instituted with a predictable promise for cure, attention must be devoted to studying the natural history of disease, its histologic and nuclear grading, stromal reaction, and whether lymphatics and/or blood vessels are involved. The results are impressive since patients with Stage IB carcinoma with lymphatic and/or blood vessel involvement treated by radical hysterectomy have had a 59.4% 5-year survival rate which has increased dramatically to 90% when there was no involvement. Other features which were analyzed, including tumor type, histologic and nuclear grades, size and number of nucleoli, and stromal leukocyte reactions showed no significant statistical relationship to survival. This may represent a bias because of the small number of cases in each group. This study helped identify the patient at high risk. The high-risk group as outlined by the parameters listed should receive additional therapy. Since the cancer had invaded a vascular channel, the authors selected these patients for combination anticancer chemotherapy. Those patients have not been followed long enough to evaluate the results of the treatment.

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