Local spread and lymph node involvement in cervical cancer

In 150 cases of carcinoma of the cervix the specimens obtained by radical hysterectomy and lymphadenectomy were examined by means of giant frontal section preparations which included adjacent parametria. Serial step sections of lymph nodes were performed. There were 44 cases of Stage IB, 13 of Stage IIA, and 93 of Stage IIB. Lymph node involvement was 16%, 33%, and 37%, respectively. The size of each cervical tumor was expressed in square millimeters as an "area-equivalent," the product of its vertical and horizontal diameters in the frontal plane. Cross relationships of tumor size, incidence of lymph node metastasis, border zone spread, and parametrial involvement were studied and are discussed. It is concluded that tumor size gives a better indication of tumor behavior than does clinical staging and constitutes an objective method of classifying tumors that the latter cannot attain.