Prognostic factors associated with radiotherapy for cervical cancer with computed tomography-detected para-aortic lymph node metastasis

Patients with cervical cancer diagnosed with a para-aortic lymph node (paln) metastasis by computed tomography (ct) scan were analyzed to identify associated prognostic factors. a total of 55 patients were reviewed,and 27 of these patients underwent extended-field radiotherapy (efrt). the median paln dose in patients receiving efrt was 45 gy (range,27-57.6 gy). of the 55 patients,28 underwent pelvic radiotherapy (rt); concurrent chemoradiotherapy (ccrt) was administered to 41 patients. the kaplan-meier method was used to calculate the actuarial rate. multivariate analysis was performed using the cox proportional hazards model. five-year overall survival (os) rates were 41% and 17.9% in patients undergoing efrt and pelvic rt (p = 0.030),respectively. age < 53 years (p = 0.023),figo stage i-ii (p = 0.002),and treatment with efrt (p = 0.003) were independent predictors of better os. the use of ccrt (p = 0.014),stage i-ii (p = 0.002),and treatment using efrt (p = 0.036) were independent predictors of distant metastasis. in patients undergoing efrt plus ccrt,the 5-year os was 50%. three-year paln disease-free rates were 8.8%,57.9% and 100% (p < 0.001) in ccrt patients who received paln doses of 0 gy,≤45 gy and ≥50.4 gy,respectively. although paln metastasis is thought to be distant metastasis in cervical cancer,efrt plus ccrt shows a good outcome,particularly in younger patients in an early figo stage. cervical cancer with a paln metastasis should not be considered incurable. doses ≥50.4 gy for treating paln may result in better disease control. © 2013 the author.