The prognostic significance of the minimum thickness of uninvolved cervix in patients with cervical carcinoma stages IB, IIA, and IIB.

The minimum thicknesses of uninvolved cervical tissues at the sites of deepest tumor invasion were evaluated in 899 patients with Stage IB, IIA, and IIB cervical carcinoma. Minimum thicknesses were greater than or equal to 10 mm in 126 (14%), 5-10 mm in 247 (27%), and less than 5 mm in 335 (38%) patients. Parametrial extension was found in 191 (21%) patients. Nodal metastasis rates were 6, 10, 22, and 55%, respectively. Patients with greater than or equal to 10-mm thicknesses did not have two or more positive nodes (P less than 0.05). The proportion of patients with two or three positive nodes increased from 3 to 10% (P less than 0.005) as the minimum thickness decreased from 5-10 to less than 5mm. The proportion of patients with four or more positive nodes increased from 3 to 22% (P less than 0.001) in cases in which tumor invaded the parametrial tissues. Five-year disease-free rates were 99, 93, 88, and 65%, respectively. Each percentage decrease was significant (P less than 0.05, 0.05 less than P less than 0.01, and P less than 0.001). These results indicate that uninvolved cervical thickness is a good indicator of nodal metastases, number of positive nodes, and patient prognosis.