Sizes of the largest metastatic nodes were evaluated as a prognostic factor in 152 patients with Stage IB to IIB cervical carcinomas treated by radical hysterectomy and postoperative irradiation. Of the 152 cases, the largest positive nodes were less than 10 mm in 24 (16%), 10-20 mm in 74 (49%), greater than or equal to 20 mm in 37 (24%), and unresectable in 17 (11%). The frequency of patients with one positive node decreased, and those patients with greater than or equal to 4 positive nodes increased along with an increase in the size of the largest nodes (P less than 0.05). Disease-free periods for 58 patients with recurrent cancer were less than 1 year in 26 (45%), 1-2 years in 18 (31%), 2-3 years in 9 (15%), and greater than or equal to 3 years in 5 (9%). There was a significant increase in cases with node sizes of greater than or equal to 20 mm with recurrence within 1 year after surgery over those with less than 20 mm (P less than 0.001). Incidence rates of 3-year recurrence were significantly different between cases with sizes of less than 10 mm and those with greater than or equal to 10 mm (P less than 0.05), as well as between cases with resectable and unresectable positive nodes (P less than 0.001). These results indicate that the size of the largest positive nodes is a good indicator of the number of positive nodes and the patient's prognosis.