Radical hysterectomy and bilateral pelvic lymphadenectomy were done on 875 patients diagnosed with cervical carcinoma Stages IB (484 patients), IIA (96 patients), and IIB (295 patients), The number of positive nodes was 0 in 620 patients (NO), one in 98 patients (Nl), two to three in 80 patients (NZ), four to 18 in 45 patients (N4), and unresectable in 32 patients. Cumulative 5-year survival rates were 89%, 8l%, 63"/0,41%, and 23y0, respectively. Significant survival reduction rates (P < 0.05) from NO to N1 were insignificant in Stage IB patients (92% versus 91%), in those patients without parametrial invasion (92% versus go%), and in those with parametrial invasion (76% versus 72%). Survival reduction rates ( P < 0.01) from N1 to N2 resulted from a reduction in IB patients without parametrial invasion (100%-71%, P < 0.01). Survival reduction rates (P < 0.05) from N2 to N4 resulted from a reduction in Stage TIB patients with parametrial invasion (60%-29%, P < 0.05). These figures suggest that the number of positive nodes is a more indicative prognostic factor than the existence of nodal metastasis, and that the 5- year survival rates of those patients with one positive node can be improved up to the level of those without nodal metastasis. Cancer 65:1923-1927,1990.
ODAL METASTASIS has long been the most important
N factor which threatens the survival of patients with cervical carcinoma.'-' Radical hysterectomy with pelvic lymphadenectomy is the treatment of choice for those patients with cervical carcinoma Stages IB to IIB. Patients with regional pelvic node metastasis are grouped in postsurgical Stage IIIB without any consideration to primary tumor or nodal metastasis status. Recent developments in pelvic surgery and postsurgical radiotherapy are improving the survival of these Stage IIIB patients,' and new prognostic factors in Stage IIIB patients are being developed. Among the many determining factors, the number of positive nodes is a very simple means for measuring the status of nodal metastasis. However, there has been little statistical analysis researchI4 in the survival rates of patients subdivided by the number of positive nodes.
This study analyzes 875 patients with cervical carci-