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Impact of surgical para-aortic lymph node staging for patients with advanced-stage cervical carcinoma undergoing definitive chemoradiation

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Objectives: Evaluate the utilization and impact of surgical para-aortic surgical staging on the survival of patients with locally advanced-stage cervical carcinoma receiving definitive chemoradiation. Methods: Patients diagnosed between 2004-2015 with… Click to show full abstract

Objectives: Evaluate the utilization and impact of surgical para-aortic surgical staging on the survival of patients with locally advanced-stage cervical carcinoma receiving definitive chemoradiation. Methods: Patients diagnosed between 2004-2015 with advanced stage (IIA-IVA) squamous, adenocarcinoma, adenosquamous carcinoma of the cervix with no distant metastases who did not undergo hysterectomy and received primary chemoradiation (external beam with or without brachytherapy) with at least one month of follow-up were identified in the National Cancer Database. Two groups were formed based on the assessment method of the para-aortic lymph node status; radiologic assessment versus surgical lymphadenectomy (PaLND). Overall survival was compared with the log-rank test following generation of Kaplan-Meier curves and a Cox multivariate model was constructed to control for a priori selected confounders. Results: A total of 3610 patients who met the inclusion criteria were identified. Surgical para-aortic staging was performed for 287 (8%) patients. Patients who had PaLND were younger (median 49 vs 53 years, p Conclusions: In a large cohort of patients with locally advanced stage cervical carcinoma, undergoing primary chemoradiation, staging PaLND was rarely performed and not associated with a survival benefit.

Keywords: carcinoma; para aortic; advanced stage; chemoradiation; surgical para

Journal Title: Gynecologic Oncology
Year Published: 2021

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