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Objectives: The cornerstone of the management of cervical cancer (CC) traditionally relies on clinicalexamination (CE) of tumor size (TS) and local extension of disease. The goal of this study is to determinethe accuracy of CE in comparison to final pathology (FP) in early operable CC.Methods: This is a multi-center retrospective review of patients with early CC (FIGO 2009 Stage IB1,IIA1). CE of TS, parametrial invasion (PI), and vaginal involvement (VI) were compared to FP.Results: The final analysis included 135 patients. Overall, there was a significant difference between CE ofTS compared to FP; mean error of 1.22 cm (p&lt;0.0001). In tumors  2cm the mean error was 1.28 cm(p&lt;0.0001). No significant discrepancy was observed in tumors &lt;2 cm (mean error: 1.10cm; p=0.5). CE ofTS of endophytic tumors was poor (mean error 1.68cm; p=0.004) compared to exophytic tumors (meanerror: 1.12 cm; p=0.693). There was no significant difference in the identification of VI between CE and FP(3.7% vs. 8.89%; p=0.067). 14.07% of patients were found to have PI on FP (p&lt;0.0001). There was nodifference in the accuracy CE of TS between non-obese (&lt;30 kg/m2) and obese patients (30 kg/m2)(p=0.061). As a result of FP, 55 patients (40.7%) received adjuvant RT and 38 patients (28.14%) wereupstaged from IB1 to IB2.Conclusion: CE of TS and PI is inaccurate, especially in tumors  2cm and

Clinically Significant Discrepancy between Clinical and Pathologic Stage of Early Operable Cervical Cancer