Detection and significance of parametrial micrometastases in early-stage cervical cancer

Background: Parametrial metastases are rare in women with small, node-negative cervical tumors. We examined the incidence of micrometastases in women with pathologically negative parametria. Patients and Methods: Patients with IA-IB cervical cancer who underwent radical hysterectomy and had no evidence of parametrial metastases were examined. Immunohistochemistry (IHC) using a cytokeratin antibody was performed in parametrial sections. Results: Among 46 patients, a parametrial micrometastasis was identified in 1 (2.2%). Micrometastases were seen in 5% of women with lymphvascular space invasion (LVSI) and in 0 (0%) patients without LVSI (p=0.43). The patient with a parametrial micrometastasis experienced recurrence and died from her disease. In a previous report, we defined patients with tumors <2 cm, negative pelvic lymph nodes, and no LVSI as being at low-risk for parametrial disease. There were no micrometastases in this group of women in the current series. Conclusion: Parametrial micrometastases are uncommon in early-stage cervical cancer.