Computed Tomography Evaluation of Paraaortic Lymph Nodes in Locally Advanced Cervical Cancer

ABSTRACT

Abstract Computed Tomography Evaluation of Paraaortic Lymph Nodes in Locally Advanced Cervical Cancer Kanyarat              Katanyoo               MD* Arcom                   Rangtaid                MD** Marisa                   Jongthanakorn     MD* Thanatip               Tantivattana         MD* * Radiation Oncology Section, Department of Radiology, BMA Medical College and Vajira Hospital ** Diagnostic Radiology Section, Department of Radiology, BMA Medical College and Vajira Hospital Objectives: To evaluate paraaortic lymph node metastatic rate in locally advanced cervical cancer by computed tomography and outcomes of treatment in the patients with paraaortic lymph nodes metastasis. Study design: Descriptive study. Subjects: All 81 patients with locally advanced cervical cancer (IIB-IVA) who were evaluated by computed tomography of whole abdomen and treated at BMA Medical College and Vajira Hospital between January 2006 - June 2008. Methods: Medical records of the patients including radiation oncology records, out-patient charts and computerized database of the institution were reviewed. Patients' age, histologic type and size of tumor, stage, computed tomography of whole abdomen reports, type of radiation therapy and results of treatment were recorded. Main outcome measures: Paraaortic lymph node metastatic rate by computed tomography, 1-year and 2-year survival rate. Results: Mean age of 81 patients was 54.5 + 10.8 years. Histopathology of cervical cancer were squamous cell carcinoma in 82.7% and adenocarcinoma in 17.3%. Clinical stage of diseases were stage IIB and IIIB in 51.9% and 48.1% respectively. Rate of paraaortic lymph node metastasis by computed tomography was 4.9%. Patients who did not have evidence of paraaortic lymph node metastasis had higher survival rate than the patients who had evidence of paraaortic lymph node metastasis with the 1-and 2-year survival rates of 93.3% and 80.4% compared to 75.0% and 0% respectively (p-value = 0.001). Conclusion: The rate of paraaortic lymph node metastasis by computed tomography of whole abdomen was 4.9%. Overall 1-and 2-year survival rates of these patients were 75.0% and 0 % respectively. Key words cervical cancer, advanced, computed tomography, paraaortic lymph nodes metastasis, survival rate   Vajira Med J 2009 ; 54 33 - 40