Para-aortic lymph node recurrence after curative radiotherapy for cervical cancer

Area of Science:

• Gynecologic Oncology
• Radiation Oncology
• Medical Oncology

Background:

• Para-aortic lymph node recurrence is a frequent event in cervical cancer.
• Established treatment guidelines for this specific recurrence pattern are lacking.
• Understanding prognostic factors is crucial for guiding patient management.

Purpose of the Study:

• To identify prognostic factors for overall survival in cervical cancer patients with para-aortic lymph node recurrence.
• To evaluate treatment outcomes in this patient cohort.

Main Methods:

• Retrospective review of 67 cervical cancer patients with para-aortic lymph node recurrence after curative radiotherapy (2001-2014).
• Analysis of prognostic factors for overall survival using univariate and multivariate methods.
• Stratification of patients based on recurrence pattern: isolated, combined with other nodes, or with distant metastasis.

Main Results:

• The 3-year overall survival rate was 42.7%.
• Histologic type (squamous cell carcinoma), non-symptomatic recurrence, isolated para-aortic lymph node recurrence, and disease-free interval were significant prognostic factors.
• Patients with isolated recurrence and a disease-free interval ≥12 months had a 3-year survival rate of 69.6% compared to 37.5% for those with <12 months (p<0.001).

Conclusions:

• Histologic type, symptom presence, disease extent, and disease-free interval are key prognostic indicators for cervical cancer patients with para-aortic lymph node recurrence.
• Isolated para-aortic lymph node recurrence with a disease-free interval of 12 months or longer is associated with superior survival outcomes.