Postoperative extended-field irradiation in patients with pelvic and/or common iliac node metastases from cervical carcinoma Stages IB to IIB

Abstract

Radical hysterectomy with pelvic and common iliac lymphadenectomy was done for 207 Stage IB (148), IIA (19), and IIB (40) cervical carcinomas. Pelvic nodal involvement was limited in 30 (14.5%) cases, whereas common iliac nodes were involved in 16 (7.7%) cases. Common iliac node metastases were significantly increased, when the number of positive pelvic nodes increased from 2 to 3 to 4 or more (21.4% to 73.3%, P < 0.05), when the tumor invaded deeper than 20 mm (3.7% to 22.2%, P < 0.001), and when the tumor extended into parametrial tissues (4.8% to 14.8%, P < 0.05). Postoperative extended-field irradiation was administered to 40 patients with nodal metastases. The 3-year disease-free rates were 85% in 24 patients with positive pelvic nodes, and 51% in 16 patients with common iliac node metastases; 70% in total. These results indicate that postoperative extended-field irradiation is essential for those patients with nodal metastases from locally resectable cervical carcinomas.