Outcome analysis of cervical cancer patients with para-aortic lymph node metastases

Background: With an estimated 122,844 new cases in 2012, and 67,000 deaths cervical cancer is a major cause of morbidity and mortality for Indian women. Because of technical, manpower and financial constraints about 80% of these cases present in a locally advanced stage of the disease; often with metastases to the paraaortic lymph nodes. Aim: This study was done to assess the outcome of the cervical cancer patients with paraaortic lymph nodes treated with concurrent chemoradiation followed by brachytherapy in respect to various prognostic factors. Materials and Method: The study included 30 cervical cancer patients with paraaortic lymph nodes treated from February 2008 to January 2010 at Mahavir Cancer Sansthan, Patna. Overall disease free survival and its relation to various factors including age, number and size of nodes, response to treatment and number of chemotherapy cycles taken was evaluated. Results: The 3year DFS was 46.66%, with distant metastasis in 40% of the patients. Response to treatment was the most significant factor affecting survival followed by size of nodes and number of chemotherapy cycles taken. Conclusion: To improve the prognosis of such patients surgical debulking of bulky nodes and adjuvant chemotherapy to decrease distant metastasis can be tried.