Prospective comparison between clinical and CT staging in primary cervical carcinoma

For 32 months, clinical and computed tomographic (CT) staging were compared prospectively in 75 patients with primary untreated cervix carcinoma. Clinical stages evaluated were IA (one patient), IB (nine) IIA (five,) IIB (18), IIIB (38), IVA (one), and IVB (three). CT agreed with clinical stage in 65%, upstaged tumors in 19%, and downstaged tumors in 16%. In comparison with surgical stage in 25 patients, CT was inaccurate in differentiating IB from IIB lesions but highly accurate in diagnosing IIIB, IVA, and IVB tumors. Pretreatment CT was most valuable in assessing parametrial and sidewall tumor extension, uterine size, endometrial tumor extension, pelvic adenopathy, and adnexal masses. Posttreatment CT in 15 patients was most valuable in assessing extrapelvic metastases to liver, paraaortic lymph nodes, and bowel mesentery. CT offers distinct advantages over current radiologic staging techniques and can be integrated into the present international Federation of Gynecology and Obstetrics classification of cervix carcinoma.