Surgical specimens from 100 patients with stage I B cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy were reviewed with respect to vascular invasion and lymphoplasmacytic infiltration. Lymph nodes from these patients were classified morphologically according to the criteria proposed by Cottier. Vascular invasion was associated with a significant increase in nodal metastases and tumor recurrence particularly to extrapelvic sites. A marked lymphoplasmacytic infiltrate around tumor cells was associated with decreased nodal metastases and tumor recurrence. There was no significant relationship between the degree of lymphoplasmacytic infiltration of the primary tumor and regional lymph node morphology.

Forty-one patients with small cell carcinoma of the uterine cervix were evaluated and treated at the University of Kentucky Medical Center from 1962 to 1974. Eighteen patients (44%) developed widespread metastases and died of recurrent cancer within 2 years of therapy. Common sites of metastases included the lung, liver, and bone. There was a significantly lower incidence of lymphoplasmacytic infiltration in small cell cancers than the keratinizing or nonkeratinizing squanmous cell carcinomas of the cervix. In addition, there was a significant increase in the number of unstimulated regional lymph nodes in patients with small cell cancer when compared with the lymph nodes of patients with the other cell types of cervical cancer. These data suggest that small cell cancer of the cervix is a highly aggressive tumor similar to small cell carcinoma of the lung and behaves quite differently from other types of squamous cell carcinoma of the cervix. Radiation therapy was superior to radical surgery in eradicating pelvic disease, but prospective studies need to be undertaken to determine the effect of adjunctive chemotherapy in patients with this rare tumor.

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