Influence of histological features and treatment on the prognosis of patients with cervical cancer metastatic to pelvic lymph nodes.

Ninety-seven patients with stage IB through IIB cervical cancer metastatic to pelvic lymph nodes treated at Magee-Womens Hospital, Pittsburgh, Pennsylvania, between 1955 and 1979 were analyzed retrospectively to determine histological factors which might predict treatment failure. All patients were treated by radical hysterectomy with a pelvic lymphadenectomy (S) or in combination with radiation therapy (S + RT) (27 and 73%, respectively) and were followed for a minimum of 5 years or until death. There were no significant differences between the two treatment groups when compared for patient age at diagnosis, distribution of disease stages, cell type, and tumor differentiation. The groups were dissimilar only with respect to the number of lymph nodes found to contain metastatic carcinoma. Significantly more patients treated by S + RT than by S alone were found to have metastasis to more than one node. Of patients treated with S alone, 65% recurred within 5 years compared with 51% with the addition of RT (P less than 0.16). The extent of both lymphocytic and polymorphonuclear infiltration of the tumor did not influence the probability of recurrence following treatment; however, tumors with a marked eosinophilic infiltration recurred significantly more frequently than those without (P less than 0.05).