Abstract

A clinicopathological analysis of 235 patients with stage IB/IIA cervical carcinoma was performed. These patients represent all those treated between 1975 and 1989 inclusive by primary Wertheim's hysterectomy at St Mary's Hospital, Manchester. We found that a significantly higher proportion of tumors from patients under 40 years of age contained mucin and that overall the adenosquamous carcinomas had a significantly greater incidence of lymph node metastases (P= 0.00049). Pelvic lymph node metastases had no effect on prognosis in these adenosquamous carcinomas but did in squamous carcinomas (P= 0.0004) and adenocarcinomas (P= 0.0001). Univariate log-rank analysis showed that variables associated with survival were: pregnancy at diagnosis (P= 0.0238), lymphatic permeation (P < 0.0001), vascular permeation (P < 0.0001), lymph node metastases (P < 0.0001), tumor volume (P < 0.0001), canal length of tumor (P= 0.0009), cervical stromal tumor-free rim (P= 0.0027), parametrial extension (P= 0.0008) and adequacy of excision (P= 0.0389). In a multivariate regression analysis (Cox's regression model) lymphatic permeation, tumor volume, pregnancy at diagnosis and lymph node metastases were independent prognostic variables.