Survival and complications in cervical cancer treated by pelvic and extended field radiation after paraaortic lymphadenectomy.
Over a 3 year period, 49 patients with invasive cancer of the cervix underwent paraaortic lymphadenectomy. Of this group, 18 were stage lb, with cervix 3 cm or smaller, and were treated by radical hysterectomy. All had negative paraaortic nodes. The remaining 31 patients had more advanced disease and underwent radiation therapy in addition to the paraaortic lymphadenectomy. Thirteen patients with positive paraaortic nodes were treated with extended field radiation to the level of the diaphragms with 4,500 rad plus intracavitary radium applications. The remaining 18 patients with negative paraaortic nodes were treated to the fifth lumbar vertebra with 5,000 rad plus radium applications. The age of the patients and stage of the disease were similar for both groups. After 13-36 months of follow-up, the survival rate was 38% for patients with positive nodes compared to 72% for those with negative nodes. About half of both groups suffered complications. More study must be given to alternative treatments of advanced carcinoma of the cervix.