Prameela Menon1
Carcinoma cervix (ca cervix) in early stages can be managed either by surgery or radiation. Surgery has an upper hand in most, especially young ones. Parametrial involvement is one of the most important factor which affect therapeutic choice. Clinical examination was the time tested method for parametrial assessment. Recently use of imaging has started to take an upper hand, which might affect the treatment.
AIMS: To find out clinical accuracy in assessing parametrium in early stage ca cervix and to compare with efficacy of CT (computed tomography) scan.
MATERIALS AND METHODS: 35 cases of early stage carcinoma cervix who underwent Werthiem’s hysterectomy in a cancer research Centre in Kerala were included. All underwent CT scan pre operatively. Accuracy was assessed according to histopathology report.
RESULTS AND CONCLUSION: Of the 35 cases without any clinically detectable parametrial involvement only 3 cases had actual paramertial involvement as per histopathology, with a diagnostic accuracy of 91.42%. CT scan even though had a 100% negative predictive value, had only 16.6 % positive predictive value. Hence clinical assessment of parametrium by an experienced person is superior to CT scan and should be relayed upon in case of disparity between the two.
