Pelvic and para-aortic lymphadenectomy in cervical cancer.
The surgical treatment of invasive cervical cancer must both remove the primary tumour and eliminate the paths by which it spreads--i.e., the lymphatics and the lymph nodes. In 359 patients, systematic pelvic lymphadenectomy yielded positive nodes in 30.3% of Stage Ib and in 44.7% of Stage IIb cases. In the 140 patients with positive nodes, the obturator group was involved in 76.4%, the external iliac group in 62.8%, and the presacral and subaortic nodes in only 4.3%. One node group was involved in 55% of the patients, two and three groups in 27.8% and 7.1% respectively. In patients with only one positive node group, the obturator nodes were involved the most often (31.4%), followed by the external iliac (21.4%) and parametrial nodes (9.2%). Nine patients with Stage Ib and 31 patients with Stage IIb disease underwent para-aortic as well as pelvic lymphadenectomy. Positive para-aortic nodes were found in 11.1% and 22.6%, respectively; 12.5% of these patients had major complications, but there was no surgical mortality. Since radiotherapy cannot sterilize positive nodes, systematic pelvic and para-aortic lymphadenectomy may improve the survival of such patients.
Winter
R
R
Petru
E
E
Haas
J
J
D001011:Aorta; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods*; D008207:Lymphatic Metastasis; D009361:Neoplasm Invasiveness; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*