Selective radiation therapy in stage IB uterine cervical carcinoma following radical pelvic surgery

Thirty-five patients with squamous cell cancer of the cervix, Stage IB, treated by radical hysterectomy and bilateral pelvic lymph node dissection are analyzed for histopathologic factors including (1) depth of cervical stromal invasion, (2) degree of differentiation of the tumor, (3) vascular tumor invasion, and (4) lymph node involvement. The influence of these factors on the outcome is studied. A correlation is found in that the advanced depth of cervical stromal invasion appears to increase the risk of nodal involvement and also the subsequent recurrence in patients with negative nodes. The Grade 2 and Grade 3 disease is more often present in patients with outer one-third cervical stromal invasion, while the vascular tumorous invasion was only found in patients with middle and mostly with outer one-third cervical stromal invasion. A subgroup of patients is described, who are at high risk for recurrent disease following surgery and who may benefit from adjuvant radiation therapy.