title: Prognostic factors and treatment outcome after radiotherapy in cervical cancer patients with isolated para-aortic lymph node metastases.
abstract: OBJECTIVE
  The purpose of the present study was to evaluate treatment outcomes and prognostic factors in cervical cancer patients with isolated para-aortic lymph node (PALN) metastases. We especially tried to evaluate PALN factors such as size, site and number.
  
  
  METHODS
  From August 1994 to December 2009, 40 cervical cancer patients with isolated PALN node metastases at initial diagnosis were selected for analysis. Patients underwent both extended field external beam and intracavitary brachytherapy. Fourteen patients received 5-fluorouracil and cisplatin (FP) and 16 patients received weekly concurrent cisplatin. Information of PALN, such as size, site, and number, was founded before PALN radiotherapy.
  
  
  RESULTS
  The median follow-up time after primary treatment was 28.5 months (range, 2 to 213 months). The 3-year overall and progression-free survival rate after primary treatment was 44.3% and 31.3%, respectively. In multivariate analysis including tumor stage, performance status, and chemotherapy, FP regimen concurrent chemoradiotherapy was more effective than radiotherapy alone (p=0.030). The 3-year progression-free survival rate was 41.9% and 11.1% in patients with PALN numbers of ≤1 and ≥2, respectively (p=0.008). The 3-year progression-free survival rate was 42.1% and 19.2% in patients with PALN size of <1.5 cm and ≥1.5 cm, respectively (p=0.031).
  
  
  CONCLUSIONS
  The radiologic features of PALN, such as number or size, can be used to determine prognosis in PALN metastatic cervical cancer patients. Furthermore, FP regimen concurrent chemoradiotherapy was associated with better patient survival than radiotherapy alone. However, more studies are required to confirm possible different treatment outcomes between FP and weekly cisplatin regimens.
authors.affiliation: Department of Radiation Oncology, Dongguk University School of Medicine, Gyeongju, Korea.
authors.forename: Hyunsoo
authors.initials: H
authors.lastname: Jang
authors.forename: Mison
authors.initials: M
authors.lastname: Chun
authors.forename: Oyeon
authors.initials: O
authors.lastname: Cho
authors.forename: Jae Sung
authors.initials: JS
authors.lastname: Heo
authors.forename: Hee-Sug
authors.initials: HS
authors.lastname: Ryu
authors.forename: Suk-Joon
authors.initials: SJ
authors.lastname: Chang
keywords: Cervical cancer; Para-aortic lymph node; Radiotherapy