Invasive squamous cell carcinoma of the uterine cervix. III. A malignancy grading system for indication of prognosis after radiation therapy.

The predictive value of a malignancy grading system embodied by 8 histopathologic parameters and of staging, age, year of admission and the different treatment modalities were compared in relation to 5- and 8-year survival. The material consisted of 196 patients in stage II according to the FIGO classification. The grading system proved superior with high significance (p less than 0.001) to the other predictors including each histopathologic parameter apart from vascular invasion (p = 0.01). All histopathologic parameters but 2 (differentiation into cell type and mitosis) exhibited significant (p less than 0.01) decrease in survival with higher grade at the 5- and 8-year controls. Patients in stage II could be divided into groups with low, intermediate and high malignancy points. Both groups of extremes showed a marked and highly significant difference in survival rates compared with the intermediate group, and the grading system made it possible to predict 60 per cent of the patients with acceptable specificity. In the group of high malignant tumours the system maintained a continual prognostic value even among patients still alive at the 5-year control.