[Place of cystoscopy in the staging of cervical cancer]

To evaluate the relevance of cystoscopy in the staging of cervical cancer, when CT and pelvic ultrasound are performed concomitantly.

Seventy one patients investigated and/or treated at Hôtel Dieu hospital in Quebec between 1st July 2000 and 1st May 2002 were included in the study. The results obtained by pelvic ultrasound or CT were compared with those obtained by cystoscopy.

Fifty eight patients (81.69%) presented a squamous carcinoma and 13 (18.31%) presented an adenocarcinoma. 25 patients (35.21%) had stage I cancer, 22 (30.99%) had stage II, 18 (25.35%) had stage III and 6 (8.45%) had stage IV. All patients were investigated by cystoscopy; 28 (39.44%) only had CT, 13 (18.31%) only had pelvic ultrasound, and 30 (42.25%) were investigated by both examinations. For stage I, II and III cervical cancer, CT and pelvic ultrasound had a NPV of 100%, while CT had a PPV of 25% for stage III cancer. For stage IV, CT had an NPV of 100%, and CT and pelvic ultrasound had a PPV of 100%.

Cystoscopy is not useful in the staging of stage I cervical cancer. For stages II, III and IV, cystoscopy is unnecessary in the case of negative CT or pelvic ultrasound. It becomes an essential diagnostic tool in the presence of a doubtful or positive result on CT or pelvic ultrasound.