Prospective histopathologic malignancy grading to indicate the degree of postoperative treatment in early cervical...

During a 9-year period, 92 women with squamous cell carcinoma of the cervix, FIGO stages IA1-IIA, were subjected to primary surgery according to Wertheim Meigs. Grading according to a malignancy grading score (MGS) and evaluation of tumor size before surgery together with surgical findings of positive nodes or insufficient surgical margin at the primary site were used to identify persons prospectively at high risk for relapse. Twenty-five women thus received postoperative treatment. Results among node-positive patients were good; only 2 out of 12 patients relapsed. Among 67 node-negative patients in stages IA2-IIA, 4 relapses occurred. These 4 patients had greater than or equal to 16 risk points according to MGS, but small tumors. Instead of tumor size, supplementary risk factor is therefore needed. Among the few patients in stage IA1, no high-point patients relapsed. These patients would probably have done just as well with less-extensive surgery.