Scalene node biopsy in advanced carcinoma of the cervix uteri

To determine the incidence of scalene node metastasis from carcinoma of the cervix uteri, all patients with advanced carcinoma of the cervix who underwent scalene node biopsy as part of a pretreatment evaluation at the University of Iowa Hospitals and Clinics have been reviewed. In 40 patients, left scalene node biopsy was indicated because of (1) metastatic para-aortic nodes (25); (2) palpable scalene nodes (2); and (3) other evidence of metastasis or unresectability. Of the 25 patients with metastasis to para-aortic nodes, seven (28%) had metastasis to the scalene node. None of these was palpable preoperatively. Because scalene node involvement indicates that the disease is beyond the scope of both surgical and radiation treatment, routine scalene node biopsy is recommended in those patients with para-aortic node metastasis.