Pretreatment staging.

Abstract

Renewed emphasis on pretreatment staging of gynecologic malignancies has resulted from a number of reports on surgical staging of malignant cervical, endometrial, and ovarian lesions. These reports have shown that by pretreatment staging, in significant numbers of patients, more advanced disease was detectable than by the usual clinical methods. From 32% to 46% of patients with stage III cervical carcicarcicarcinoma have been found to have metastatic disease in the para-aortic nodes. Diaphragmatic and para-aortic node metastases have been reported in patients with ovarian carcinoma recently in significantly higher incidences than as previously detected. The pelvic lymph nodes have been shown to be involved in 11% to 13.5% of patients with stage I endometrial carcinoma. Twelve and one-half percent had metastases to the para-aortic nodes. These data suggest the need for more accurate definition of extent of disease prior to treatment. Improvement in survival rates will not necessarily follow, but modifications in treatment must be tried.