THE POSSIBLE ROLE OF ULTRASOUND IN EARLY CERVICAL-CANCER

The value of preoperative ultrasonography to detect lymph node metasta ses in patients with early cervical carcinoma (stage IB-IIA) was inves tigated in 111 patients. Comparison was made between ultrasound and th e operative histopathologic findings in 109 patients and with fine-nee dle biopsy in 2 patients. The positive predictive value was 71%, and t he negative predictive value was 84%. Sensitivity was 23%, specificity was 98%. Lymph node metastases were found in 19% (21 patients) by ope rative histopathologic examination; these patients received subsequent radiotherapy. The rest, 92 patients with no lymph node metastases at Meigs' operation, were followed by abdominal and transvaginal ultrason ography as well as clinical examination at 6, 9, 12, 18, 24, 36, and 4 8 months postoperatively to detect recurrences. The recurrence rate wa s 9.8%. Ultrasound alone detected only one recurrence in an asymptomat ic patient. We conclude that ultrasonography is not reliable in the pr eoperative detection of lymph node metastases. Moreover, ultrasound ex amination presents no advantage over clinical examination in early det ection of asymptomatic recurrent cervical cancer after radical hystere ctomy. (C) 1995 Academic Press, Inc.