LYMPH-NODE METASTASES AND PROGNOSIS IN PATIENTS WITH STAGE IA(2) CERVICAL-CANCER

Ninety-four patients with squamous cell carcinoma invading the cervica l stroma to a depth of >3.0-5.0 mm with 7 mm or less in horizontal spr ead (FIGO Stage IA,) were evaluated. Depth and lateral extent of strom al invasion were verified using an ocular micrometer. Cell type and ly mph vascular space invasion (LVSI) were recorded in each case, Patient s were treated primarily by radical hysterectomy with pelvic lymphaden ectomy, and those with lymph node metastases were offered postoperativ e radiation, Following treatment, patients were seen at 3-month interv als for 2 years, and every 6 months thereafter, The mean duration of f ollow-up was 6.9 years (range 0.4-23.5 years). Seven of 94 patients (7 .4%) had lymph node metastases. Five patients had 1 positive node, 1 p atient had 2 positive nodes, and 1 patient had 3 positive nodes, Five patients developed recurrent cancer and 4 died of disease, LVSI was pr esent in 31 cases (33%). Tumor recurrence was significantly increased in patients with positive LVSI (9.7% vs 3.2%). The 5-year survival rat e of patients with LVSI was 89% vs 98% in patients without this findin g (P = 0.058). The 5-year survival rate of all Stage IA, cervical canc er patients was 95%. Patients with Stage IA(2) cervical cancer have a significant risk of lymph node metastases and should be treated by rad ical hysterectomy with pelvic lymphadenectomy. LVSI is an important pr ognostic variable in these patients and should be recorded in all case s. (C) 1996 Academic Press Inc.