title: Outcomes of cervical cancer and positive para-aortic lymph nodes in the modern era of chemoradiation.
abstract: OBJECTIVE
  Patients with cervical cancer with positive para-aortic lymph nodes have a poor prognosis. Our primary aim was to describe outcomes among this subgroup in the era of modern chemoradiation.
  
  
  METHODS
  Patients with histologically confirmed cervical cancer metastatic to their para-aortic lymph nodes diagnosed between 1998 and 2011 and treated with curative intent were included in this analysis. Surgicopathologic, demographic, and outcome data were collected. Descriptive and survival statistics were generated to evaluate overall survival (OS) and progression-free survival (PFS) and to compare outcomes by treatment. P values were generated using both Wilcoxon and log-rank methods and listed respectively.
  
  
  RESULTS
  The median PFS was 19 months. The median OS was 23.4 months. The median PFS for radiation only was 14 months and for chemoradiation was 20 months (P = 0.27 and 0.60, respectively). There was no difference in median OS for the radiation-only group versus chemoradiation. The median OS stratified by stage was 32 months (stage I), 21 months (stage II), 19.4 months (stage III), and 19.8 months (stage IV; P = 0.17 and 0.22).
  
  
  CONCLUSIONS
  Our study shows a median OS of 23 months, which is less than what was documented in the literature. Despite the use of modern chemoradiation therapy, most of the cohort died within 3 years. The low OS presented in our study highlights the limitations of the current treatment regimens and the need for identification of for more effective therapy.
authors.affiliation: *Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK; †Women and Infant's Hospital, Brown University, Providence, RI; and ‡Magee-Women's Hospital of UPMC, Pittsburgh, PA.
authors.forename: LaToya J
authors.initials: LJ
authors.lastname: Perry
authors.forename: Cara
authors.initials: C
authors.lastname: Mathews
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Nugent
authors.forename: Regina
authors.initials: R
authors.lastname: Farrell
authors.forename: Kristen
authors.initials: K
authors.lastname: Zorn
authors.forename: Kathleen
authors.initials: K
authors.lastname: Moore
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001012:Aorta, Abdominal; D059248:Chemoradiotherapy; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008875:Middle Aged; D009825:Oklahoma / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents