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.