Clinically Significant Discrepancy between Clinical and Pathologic Stage of Early Operable Cervical Cancer

Author Info

Constantine Gorelick Jennifer McEachron Katherine Economos Margaux J. Kanis Nikita Malakhov Victoria Hastings Yi-Chun Lee

Corresponding Author

Jennifer McEachron
Division of Gynecologic Oncology, Downstate Medical Center, University Hospital of Brooklyn, Brooklyn, NY

A B S T R A C T

Objectives: The cornerstone of the management of cervical cancer (CC) traditionally relies on clinical examination (CE) of tumor size (TS) and local extension of disease. The goal of this study is to determine the accuracy of CE in comparison to final pathology (FP) in early operable CC. Methods: This is a multi-center retrospective review of patients with early CC (FIGO 2009 Stage IB1, IIA1). CE of TS, parametrial invasion (PI), and vaginal involvement (VI) were compared to FP. Results: The final analysis included 135 patients. Overall, there was a significant difference between CE of TS compared to FP; mean error of 1.22 cm (p<0.0001). In tumors  2cm the mean error was 1.28 cm (p<0.0001). No significant discrepancy was observed in tumors <2 cm (mean error: 1.10cm; p=0.5). CE of TS of endophytic tumors was poor (mean error 1.68cm; p=0.004) compared to exophytic tumors (mean error: 1.12 cm; p=0.693). There was no significant difference in the identification of VI between CE and FP (3.7% vs. 8.89%; p=0.067). 14.07% of patients were found to have PI on FP (p<0.0001). There was no difference in the accuracy CE of TS between non-obese (<30 kg/m2 ) and obese patients (30 kg/m2 ) (p=0.061). As a result of FP, 55 patients (40.7%) received adjuvant RT and 38 patients (28.14%) were upstaged from IB1 to IB2. Conclusion: CE of TS and PI is inaccurate, especially in tumors  2cm and

Article Info

Article Type

Research Article

Publication history

Received: Thu 02, Apr 2020
Accepted: Mon 20, Apr 2020
Published: Thu 23, Apr 2020

Copyright

© 2023 Jennifer McEachron. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.COR.2020.04.06