[Lymphatic metastasis in patients with invasive cervical carcinoma after initial treatment]

Lymphatic metastasis is the major recurrent way in invasive cervical carcinoma. This study was to summarize the characteristics, treatment, and prognosis of lymphatic metastasis in invasive cervical carcinoma patients after initial treatment.

Clinical data of 123 invasive cervical carcinoma patients with lymphatic metastasis after initial treatment at Zhejiang Provincial Cancer Hospital between 1990 and 2000 were analyzed. Of the 123 patients, 5 received operation alone, 45 received operation and adjuvant radiotherapy, and 73 received radiotherapy alone. All patients received salvage treatment of local radiotherapy and/or chemotherapy.

Of the 123 patients, 95 (77.2%) had supraclavicular lymph node metastasis, 62 (50.4%) had para-aortic lymph node metastasis, 12 (9.8%) had inguinal lymph node metastasis, and 3 (2.4%) had axillary lymph node metastasis. The median duration from initial treatment to lymphatic metastasis was 14 months. Of the 123 patients, 36 developed metastasis within 6 months after initial treatment and 87 developed metastasis more than 6 months later. The 3-and 5-year overall survival rates were 15.0% and 1.5%. The 3-year survival rates were 23.1% for the 76 patients with lymphatic metastasis alone, and 4.7% for the 47 patients with both lymphatic metastasis and pelvic recurrence or hematogenous metastasis. Multivariate analysis revealed that the duration from initial treatment to lymphatic metastasis and concomitance of hematogenous metastasis and/or pelvic recurrence were significant prognostic factors of invasive cervical carcinoma.

Invasive cervical carcinoma patients with lymphatic metastasis alone after initial treatment may benefit from aggressive salvage treatment.