Para-aortic node biopsy in staging women with cervical, ovarian and endometrial carcinoma: a review

In women with gynecologic malignancies the para-aortic lymph nodes are not routinely treated. However, pretherapy surgical staging has now disclosed an incidence of para-aortic node metastasis of 10.3% for presumed stage I and II ovarian cancer, 8.0% for stage I endometrial carcinoma, and 23.5% for stage II, III, and IV cervical cancer. Prospective trials to evaluate therapy directed to the para-aortic nodes in women with early ovarian and endometrial carcinoma have not been carried out. Moreover, the results of high dose irradiation to biopsy proven metastasis to the aortic lymph nodes from cervical cancer has resulted in only 11.9% survival without recurrence at two years.