Para-aortic lymph node recurrence in patients with cervical cancer treated with postoperative irradiation to the pelvis.
A retrospective analysis of para-aortic lymph node (PALN) metastasis in patients with cervical squamous cell cancer who received prophylactic postoperative irradiation to the pelvis, was carried out.


METHODS
Sixty-seven patients had no intra-pelvic lymph node (IPLN) metastasis (n 0), whereas 33 had IPLN (n 1). All patients received prophylactic external beam irradiation with a total dose of 50 Gy to the entire pelvis followed by intravaginal boost. Only 5 patients received a prophylactic PALN irradiation with a total dose of 30-50 Gy.


RESULTS
No patients with n 0 developed para-aortic recurrence. However, 6 of 33 patients with n 1 developed PALNs recurrence but only 3 patients developed isolated PALN recurrence. There was no difference in survival between patients with PALNs irradiation and patients without PALNs irradiation.


CONCLUSIONS
Routine prophylactic irradiation to PALNs is not necessary even for patients with IPLN metastasis except for the selected patients in the management of cervical cancer.
Takahashi
M
M
Department of Radiology and Radiation Oncology, Gunma University School of Medicine, Japan.
Mitsuhashi
N
N
Sakurai
H
H
Hayakawa
K
K
Niibe
H
H
D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D017211:Treatment Failure; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery