Some Factors of Interest in the Grading of Carcinoma

Abstract

In a study of relation between the histological findings and the results of radiation therapy in a group of cases of carcinoma of the cervix uteri, Thibaudeau and Burke, of Buffalo, have shown that histological grading and malignancy indices are of limited value in the prognosis in cases of carcinoma cervix uteri (1). A review of 28 cases, clinically well for 5 years, following radiation therapy, shows 25 per cent in Grade III, 50 per cent in Grade II, 25 per cent in Grade I. They followed Broders9 classification of 1926 (2) of Grade I, 0–50 per cent undifferentiated, Grade II, 50–75 per cent, Grade III, 75–100 per cent undifferentiated. They arranged their cases in the 5 clinical groups used at the Malignant Institute, and also used Hueper9s malignancy index (3). As to this index, they feel personal equation too marked a factor in estimation. At the last meeting of the American Association for Cancer Research, MacCarty, Warthin, Bell, Plaut and Ewing, discussed fully the question of grading and its significance (4). MacCarty stated: “A very good piece of scientific observation has been spoiled by the clinicians. There are too many factors connected with the prognosis to allow practical clinical grading. There are two grades of therapy for tumors: if a tumor is malignant treat it radically; if it is benign treat it locally. Clinical interpretations have gone too far.” Bell brought up the difference of grade in areas of a tumor. Plaut was unable to find any relationship between histological picture and final outcome in carcinoma of cervix.