[A clinical and pathological study on paraaortic lymph node metastasis in uterine cervical carcinoma]

Three hundred and three patients with uterine cervical cancer underwent radical hysterectomy including Paraaortic lymph node (PAN) dissection between June, 1982 and March, 1990. We analyzed the relationship between PAN metastasis and the clinical stage, histologic type, parametrial invasion and pelvic lymph node (PLN) metastasis, and obtained the following results. 1) The incidence of PAN metastasis in clinical stages Ib, II and III was 0.9%, 4.5% and 16.7%, respectively. 2) The PAN metastasis rate in case of adenocarcinoma was 8.3% which tended to be higher than that for squamous cell carcinoma (4.9%) and mixed carcinoma (3.2%). 3) Deeply invading carcinoma penetrating to the parametrium (including the parametrial initial zone) was seen in 15 out of 16 cases (93.8%) with PAN metastasis. PAN metastasis was rare in cases without parameterial invasion (1/114). 4) Positive PAN was found in 48.3%, 34.8% and 41.9% of cases with metastasis in more than four lymph node groups, bilateral PLN and common iliac lymph node (CILN), respectively. The present results suggest that a regular careful check up for PAN metastasis is necessary for case with multiple PLN metastasis (bilateral and more than four groups) and CILN metastasis.