The significance of tumor size in clinical stage IB cervical cancer: Can a cut-off figure be determined?

The purpose of this study was to investigate the influence of tumor size on pathologic variables and the prognosis of patients diagnosed as clinical stage IB cervical cancer. Five hundred sixty six patients with clinical stage IB cervical cancer treated surgically at the Aichi Cancer Center between 1976 and 1995 were studied. The incidence of pathologic variables that increased as tumors enlarged was unchanged beyond 4.0 cm. Although univariate analysis revealed that the prognosis worsened as a tumor enlarged, there was no significant difference in prognoses between 3.1-4.0 cm and 4.1-5.0 cm tumors. While multivariate analysis showed tumor size as an independent prognostic variable, there was no difference between the odd ratios of 3.1-4.0 cm and 4.1-5.0 cm tumors. Tumor size was an independently significant risk factor for the prognosis of clinical stage IB cervical cancer. While the definition of 4.0 cm as a cut-off point was useful as far as determining an association with pathologic variables, it may be an insufficient indicator of poor prognosis. The "bulky" tumors should be defined as clinical lesions greater than 5.0 cm, though few patients would have tumors that meet that criterion.