The prognostic significance of number of positive nodes in cervical carcinoma stages IB, IIA, and IIB.

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 (N0), one in 98 patients (N1), two to three in 80 patients (N2), four to 18 in 45 patients (N4), and unresectable in 32 patients. Cumulative 5-year survival rates were 89%, 81%, 63%, 41%, and 23%, respectively. Significant survival reduction rates (P less than 0.05) from N0 to N1 were insignificant in Stage IB patients (92% versus 91%), in those patients without parametrial invasion (92% versus 90%), and in those with parametrial invasion (76% versus 72%). Survival reduction rates (P less than 0.01) from N1 to N2 resulted from a reduction in IB patients without parametrial invasion (100%-71%, P less than 0.01). Survival reduction rates (P less than 0.05) from N2 to N4 resulted from a reduction in Stage IIB patients with parametrial invasion (60%-29%, P less than 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.