The Histological Classification of Cancers of the Uterine Cervix and the Relation Between the Growth Structure and the Results of Radium Treatment

Abstract

The value of histological grading as a means of determining prognosis and estimating the radiosensitivity of malignant tumours is still uncertain. The subject has attracted wide attention since Broders (1922) showed, in squamous cancer, that the success of surgical treatment was closely related to the type of growth and the degree of cell activity. In cancer of the cervix particularly, the marked differences which occur in structure have led to many attempts to trace a relationship between the histological type and the clinical progress of the disease. The number of five-year cures reported by Broders (1922) for the most differentiated type of squamous cancer of the cervix treated by surgery was 53.33 per cent as compared with only 9.57 per cent for the most rapidly growing and least differentiated tumours. The corresponding figures given by Martzloff (1927) were 63.6 per cent and 14.01 per cent. After radiotherapy Healy and Cutler (1928) found an equally important but different relationship, more cures being obtained with the anaplastic, rapidly growing tumours than with the highly differentiated and more slowly growing forms of cancer. Adenocarcinomata Regaud for many years has considered should be treated preferably by surgery because of their insensitivity to radiation. Apart from the need of a large number of cases treated by a uniform method and followed for a sufficient time, a study of the subject is complicated by the difficulties inherent in the problem of classifying cancer growths into separate and clearly defined groups and by the fact that no method of grading has as yet been generally adopted or accepted as satisfactory.