Operative therapy for stage IIb cervical cancer

A total of 506 cases of cervical cancer, Stages Ib and IIb, operated on according to Wertheim and Meigs, were retrospectively (1972-1985) evaluated with respect to their clinical and morphological aspects. After 1978 a more intensive histological evaluation of the specimen was performed, resulting in the examination of a larger number of pelvic lymph nodes. The number of lymph nodes infiltrated depends on tumour stage, invasion depth, regional lymphovascular invasion of the tumour edge and parametria, and on haemangiosis carcinomatosa. The five-year survival rates were determined by the parametrial infiltration and by the number of positive pelvic lymph nodes. If neither the parametria nor the lymph nodes were infiltrated by the tumour the survival rate was 69%, whereas in cases of lymphovascular invasion of the parametria without infiltrated lymph nodes the rate decreases to 80%; in cases of tumour infiltration of both lymph nodes and parametria the cure rates are worst (62%). The operation on cervical cancer of Stages Ib and IIb with a thorough histological evaluation of the excised tissue therefore has a high prognostic value, but it also probably has better cure rates than is the case with radiological treatment.