Value of computerized axial tomography in cervical cancer

Results of preoperative abdominopelvic computerized axial tomography were compared with operative findings in 58 patients undergoing laparotomy for cervical cancer. Patients with stages IA, IB, IIA, IIB, IIIB, and recurrent carcinoma of the cervix were included. The abdominopelvic contents were divided into retroperitoneal, intraperitoneal-abdomen and intraperitoneal-pelvic compartments for purposes of evaluation. The overall sensitivity was 47.6% and the overall specificity was 96.4%. The highest sensitivity was associated with intraperitoneal-pelvic findings while the lowest sensitivity was associated with pelvic lymphadenopathy. The highest false positive results were associated with parametrial involvement. Computerized axial tomography is probably not cost effective in stage IB or IIA disease. It may be cost effective in stage IIB or greater as well as in recurrent cervical cancer. In the event a positive finding can be confirmed by needle aspiration and cytology, a staging procedure or exenteration attempt can be avoided.