THE RISK OF HEMATOGENIC METASTASIZING IN CERVICAL-CANCER

Metastasis development in cervical cancer was analysed retrospectively to determine whether haematogenic metastases occurred with higher fre quency in younger women than in older women. Based on clinical and mor phologic data, parameters for the identification of a high-risk group for the development of haematogenic metastases were established. The d ata of 533 patients who underwent therapy at the University Women's Ho spital Berlin-Charlottenburg from 1970 to 1984 were evaluated. 11.8% o f these patients developed haematogenic metastases. No significant dif ference was found in the 5-year risk for development of haematogenic m etastases between different age groups. Furthermore, no increase in th e incidence of haematogenic metastases was found in women under 35 yea rs in the course of time. The influence of pretreatment characteristic s for the development of haematogenic metastases was assessed in 185 p atients who underwent surgery for cervical cancer from 1979 to 1984. U nivariate as well as multivariate regression analysis of histopatholog ic characteristics in the surgical specimens revealed blood vessel inv asion, tumour grading, dissociated tumour growth, and number of mitose s as important parameters for the occurrence of haematogenic metastase s. In this study group, patient age strongly influenced the occurrence of haematogenic metastases. In contrast, prognostic parameters for th e development of local recurrence of the disease were derived from mor phologic data which described the locoregional spread of the tumour (s taging, tumour growth beyond the cervix, involvement of the corpus ute ri, and lymph node in volvement). Our data provide precise prognostic factors for the definition of a high-risk group for the development of haematogenic metastases.