Para-aortic lymphadenectomy

Para-aortic lymphadenectomy is a procedure that has an undoubted place within the management spectrum of gynaecological malignancies. It should be performed in selected cases by trained gynaecological oncologists who are versed in the technique and in the management of potential complications. The removal and histological examination of nodal tissue remains the most accurate method of assessing the precise extent of disease spread. Its main value, therefore, is as part of a surgical staging procedure, which provides reliable survival information. However, it is still questionable whether treatment planning based on this knowledge, including modification of adjuvant therapy, results in improved survival figures. Until more data are available to clarify the degree of patient benefit, para-aortic lymphadenectomy is a technique that is more suitably practised in investigative oncological centres rather than on a widespread clinical basis.