Uterine body invasion of carcinoma of the uterine cervix as seen from surgical specimens

Abstract

To estimate the actual states of uterine body invasion of carcinoma of the uterine cervix, 301 radically hysterectomized specimens were reviewed histologically. Incidence of uterine body invasion was 21.6% in all cases (65 cases out of 301), 7.8% in stage Ib, 25.5% in stage IIa, and 38.2% in stage IIb. Most of the positive invasion cases had spread to other surrounding tissues. Vaginal wall was invaded in 58.5% of all positive cases, parametrial infiltration was recognized in 87.7%, and pelvic lymph node metastasis was seen in 52.3%. On the contrary, in negative cases these were 33.9, 19.1, and 15.7%, respectively. There was a higher incidence of the L type of Imai's CPL classification among positive cases of uterine body invasion than among negative cases (81.5% vs 38.1%). When cervical cancer spread into the uterine body, peritoneal carcinomatosis and distant metastasis increased. Thus the outcome of patients with positive invasion was, naturally, poor. Patients with negative invasion had a 5-year survival rate of 92.4%, compared to 53.8% in patients with positive uterine body invasion. These results suggest that uterine body invasion of carcinoma of the uterine cervix is an important prognostic factor and treatment should be modified in such cases.