Early-stage cervical cancer: agreement between ultrasound and histopathological findings with regard to tumor size and extent of local disease.

OBJECTIVES: To determine the agreement between ultrasonographic and histological examination of the cervix in patients with early stage cervical cancer with regard to tumor size and local extent of the disease. METHODS: Eighteen patients with histologically proven cervical cancer stage IB1-IIA according to traditional clinical staging (FIGO 1988) and scheduled for radical surgery underwent a standardized transvaginal ultrasound examination: the maximum tumor length, anterior-posterior tumor diameter, tumor width, tumor area, depth of cervical stroma invasion, and the minimal thickness of tumor free cervical stroma on sagittal and transverse planes through the cervix were measured, and the local extent of the disease into the parametria and vagina was evaluated. The surgical specimens were examined using a dedicated method of histopathological examination. The results of the ultrasound and histopathological examinations were compared. RESULTS: Limits of agreement were wide and the Inter-Class Correlation Coefficient (Inter-CC) was low (0.51 to 0.58) for three of the four measurements taken to represent the minimal depth of tumor free cervical stroma, i.e. the results for the measurements taken posteriorly and laterally. The limits of agreement were smaller and the Inter-CC values were higher (0.74 - 0.92) for the depth of cervical stroma invasion and for the tumor size measurements. Histological examination revealed parametrial cancer infiltration in four patients. All these cases were detected at ultrasound examination with no false positive results.