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Endometrial extension of carcinoma of the uterine cervix: A prognostic factor that may modify staging
Author(s) -
Perez Carlos A.,
Camel H. Marvin,
Askin Frederic,
Breaux Sherry
Publication year - 1981
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19810701)48:1<170::aid-cncr2820480128>3.0.co;2-0
Subject(s) - medicine , cervix , carcinoma , lymphadenectomy , incidence (geometry) , curettage , endometrium , gynecology , radiation therapy , radiology , cancer , optics , physics
Abstract A retrospective review was done of 473 patients with histologically proven primary carcinoma of the uterine cervix on whom a dilatation and curettage (D & C) was performed during the initial workup. The pathologic features of the D & C specimens were classified as: (1) endometrial stromal invasion of cervical carcinoma; (2) tumor only, cervical carcinoma in D & C, normal endometrium absent; (3) admixture of normal endometrium and cervical carcinoma (contamination); (4) D & C negative for tumor. The patients were staged according to the FIGO classification. Eighty‐two percent (388) of the patients were treated with radiation alone and the rest with a combination including surgical procedures (usually radical hysterectomy with lymphadenectomy). The three‐ and five‐year survival rates were 10% to 20% lower for patients with D & C showing stromal invasion or tumor only than in patients with admixture or negative D & C. These results were coupled with an appreciably higher number of distant metastases in the patients with positive D & C and a lower incidence in patients with negative D & C. The authors suggest that endometrial extension of carcinoma of the uterine cervix may be an important factor in the staging classification of these patients and recommend that D & C always be done in the initial evaluation. Because of the high incidence of distant metastasis, effective adjuvant therapy must be developed to improve the present therapeutic results.