CLINICAL RESULTS OF LYMPHOGRAPHY IN CANCER OF UTERINE CERVIX - RETROSPECTIVE STUDY OF 542 CONSECUTIVE, UNSELECTED PATIENTS

From 1961 to 1976, 542 patients were evaluated with foot lymphography for cancer of the cervix. A group of 341 patients had lymphangiography as part of the initial diagnostic work-up. The overall incidence of positive examinations was 25% (9 % stage I, 29 % stage II, 46% stage III, 50% stage IV). In the 115 patients who had pelvic surgery the overall diagnostic accuracy of lymphography was 88%, with 2 false positive and 12 false negative reports. A second group of 90 patients was evaluated in the follow-up without clinical evidence of disease, and the incidence of metastases was 17%. Finally, a group of 111 patients was studied for recurrence, and in this group the incidence of metastases was 51%. As regards site of involvement, the external iliac chains were involved in 93 to 96 % of the cases, the common iliac in 34 to 79%, and the para-aortic in 17 to 36% in the different clinical conditions. The highest incidence of para-aortic metastases was found in the clinically initial stages (I and II) and in the recurrences. The lymphographic involvement of the retroperitoneal nodes was usually limited to a single region (41%) or two regions (37%). Only in 22 % of the positive cases was a diffuse involvement of the retroperitoneal node chains evident.