The staging of cervical cancer: Inevitable discrepancies between clinical staging and pathologic findings

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Abstract

Three hundred seventy previously untreated patients with invasive cervical carcinoma were evaluated, staged, and treated at the University of Kentucky Medical Center from January 1964, to July 1970. Of these, 125 patients were operated upon within 4 weeks of staging. The initial stage was found to be correct in 66 per cent of the cases, with staging accuracy decreasing from Stage I (78 per cent) to Stage III (25 per cent). The most common error was failure to accurately define the extent of parametrial disease. The most effective method of staging was the conventional system which consists of dividing cervical carcinoma into four stages as originally presented by the League of Nations in 1929 and modified by the Cancer Committee of the International Federation of Gynecology and Obstetrics. The TNM staging system did not alter staging accuracy. It is suggested that in certain selected patients diagnostic laparotomy may be indicated.

References (23)

  • J.L. Bean et al.

    Amer. J. Obstet. Gynec

    (1969)
  • E. Henriksen

    Amer. J. Obstet. Gynec

    (1949)
  • W. Liu et al.

    Amer. J. Obstet. Gynec

    (1955)
  • J.V. Meigs et al.

    Amer. J. Obstet. Gynec

    (1952)
  • F.N. Rutledge et al.

    Amer. J. Obstet. Gynec

    (1958)
  • H. Schmitz

    Amer. J. Obstet. Gynec

    (1927)
  • H. Schmitz

    Amer. J. Obstet. Gynec

    (1932)
  • American Joint Committee for Cancer Staging and End Results Reporting Clinical Staging Systems for Carcinoma of the Cervix

    (1964)
  • Annual Report on the Results of Radiotherapy in Cancer of the Uterine Cervix

    (1941)
  • Annual Report on the Results of Radiotherapy in Carcinoma of the Uterine Cervix

    (1952)
  • Annual Report on the Results of Treatment in Carcinoma of the Uterus

    (1955)
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