Comprehensive, therapeutic retroperitoneal pelvic and infrarenal aortic lymphadenectomy for advanced cervical...

This 49-year-old female with stage III cervical carcinoma presented with a PET/CT scan showing bilateral pelvic and common ileac adenopathy. A retroperitoneal approach to resect the nodes well above the highest documented PET positive region was employed in July 2011. The bilateral infrarenal, bulky inframesenteric and pelvic nodes were comprehensively removed, revealing bilaterally positive nodes in 5/36 pelvic nodes, 13/25 inframesenteric nodes, and 3/20 infrarenal nodes (these latter not detected on PET). Image-modulated radiation to 10 cm above the renal vein, with concurrent cisplatin chemotherapy was undertaken, resulting in a disease-free status thus far.