Endometrial carcinoma, stage II: route and extent of spread to the cervix

The spread of endometrial carcinoma to the cervix was studied in 19 hysterectomy specimens from patients with stage II disease. None received preoperative irradiation. The tumor was found to spread in continuity from corpus to endocervix, where it involved only the surface in five patients, the surface and underlying stroma in 13, and only stroma in one case. Surface only involvement tended to correlate with a lower grade of tumor, less myometrial invasion, and a better prognosis than was associated with endocervical stromal invasion. Review of preoperative endocervical curettings, in the ten patients who underwent this fractional procedure, revealed tumor in all specimens. The authors were unable, however, to distinguish stromal involvement from surface only involvement by study of these curettings.