The influence of staging laparotomy for cervical cancer on patterns of recurrence and survival

A matched paired study of surgically staged and non-surgically staged patients with stage II and III cervical carcinoma from October 1974 through August 1987 was retrospectively performed. Eight of 55 (13.8%) had para-aortic lymph node involvement. After tailored extended field radiation 2/8 (25%) remain alive without evidence of disease. Patient survival although slightly in favor of the unstaged group was similar. Patterns of recurrence were similar amongst treatment groups. Para-aortic nodal recurrence, despite tailored radiation therapy, was identical (5.4%) in the staged and unstaged groups. Only one patient (not surgically staged) had an isolated para-aortic recurrence. With the morbidity of an operative procedure and similar survival rates and para-aortic nodal recurrence rates, the value of staging laparotomy in improved patient survival is questioned. Pelvic failure and other distant metastases continue to be the major sites of recurrences.