The Clinical Value Of Para-aortic Lymphadenectomy In Patients With Stage IB2and â…¡A2Cervical Cancer

Objective:To investigate the clinical value of para-aortic lymphadenectomy in patients with stage IB2and IIA2cervical cancer.Methods:96patients with stage IB2and IIA2a cervical cancer were divided into two groups:control group (n=50,radical hysterectomy and pelvic lymphadenectomy, bilateral ovarian transposition if the patients less than45years old and the ovarians look normal) and study group (n=46, radical hysterectomy and pelvic lymphadenectomy and para-aortic lymphadenectomy). Complications、recurrence、survival、 the relationship between the rate of para-aortic lymph node metastasis and the rate of pelvic lymph node metastasis were retrospectively analyzed.Evaluate the value of para-aortic lymphadenectomy to the postoperative therapy.Result:Total incidence of postoperative complications pelvic lymph node metastasis in study group was not significantly lower than that in control group (26.1%and54.3%vs36%and58%,P>0.05). The incidence of para-aortic lymph node metastasis was19.6%.The incidence of recurrence in study group was significantly lower than that in control group (13%vs34%, P<0.05). There was relationship between the number of the pelvic lymph node metastasis and para-aortic lymph node metastasis.By the univariate survival analysis, there was relationship between para-aortic lymph node metastasis, postoperative treatment and36months,48months median survival time on the study groups (P<0.05), there was relationship between Cervical myometrial invasion, histological type and36months,48months median survival time on the control group. Postoperative therapy significantly prolonged the median survival time in the study group(P<0.05). Two groups of patients were36months,48months overall survival (OS) and disease-free survival (DFS) are differences in the comparison(P<0.05), the study group survival rate higher than the control group. Multivariate analysis showed that the depth of tumor infiltration (P=0.035), number of pelvic lymph node metastasis (P<0.05) are two independent common prognostic factors on the two groups, para-aortic lymph node-positive (P=0.031) is an independent prognostic factor for cervical cancer.Conclusions:In cervical cancer, There was relationship between the number of the pelvic lymph node metastasis and para-aortic lymph node metastasis.The patients who have the para-aortic lymph node metastases given corresponding auxiliary treatment can reduce distant recurrence and improve survival rate.