Pathological classification for staging of squamous cancer of the cervix

HE increased use of surgery in the treat-T ment of cervical cancer calls for a specific pathological classification of the disease.T h e clinical classification now widely used has value in the selection of patients for radiation or surgery.However, it is illogical to employ it after the patient has been treated surgically and the exact status has been determined.T h e pathological classification to be proposed is ideal and precise, since it is based on established pathological principles.I t incorporates the sum total of all of the clinical, surgical, and pathological observations made on a given case, This is possible especially when laparotorriy and radical hysterectomy and lymphadenectomy have been performed arid the specimen has been thoroughly studied by sectioning, as in Fig. 1.T h e pathological classification provides a basis for the reporting of end results on those patients treated surgically.It may also be used for follow-up prognosis-to classify irradiated patients coming to autopsy without surgery and those developing clinical recurrence.Classifications of cervical cancer now in use arc based on the clinical estimation of the anatomical extent or "stage" of the lesion and the microscopic appearance or "grade."As such, the clinical classification should be restricted to its original purpose and used either for the selection of patients to be operated upon or to classify patients treated by irradiation, thus providing a uniform basis for the reporting of end results obtained by radiation therapy in various clinics throughout the world.Those treated surgically need a similar "yardstick," for comparison of end results.Javert and Hofammann13 proposed a pathological classification lor endometrial cancer based priniarily on the surgical pathologist's gross and microscopic examination of the panhysterectomy specimen, including the pelvic lymph nodes.It forms the basis for this classification 01 epidermoid cancer of the cervix.