eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
Current Issue Archive Supplements Articles in Press Journal Information Aims and Scope Editorial Office Editorial Board Register as Author Register as Reviewer Instructions for Authors Abstracting and indexing Subscription Advertising Information Links
SCImago Journal & Country Rank

Interview with Professor Janusz Skowronek
ABS 2015
vol. 10
Original paper

The analysis of the long-term outcomes in elderly women treated for locally advanced cervical cancer

Krzysztof Koper, Konrad Dziobek, Roman Makarewicz, Joanna Terlikiewicz, Magdalena Dutsch-Wicherek

J Contemp Brachytherapy 2018; 10, 5: 411–417
Online publish date: 2018/10/31
View full text
Get citation
JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero
Locally advanced cervical cancer (LACC) should be treated with a combination of external irradiation and brachytherapy with concurrent chemotherapy. However, as cervical carcinoma cells can disperse by way of the lymphatic system to either pelvic or para-aortic nodes, planning the extent of radiation requires precise information about the spread of the disease to the lymph nodes, especially to the para-aortic area.

Material and methods
All of the 75 women included in our study underwent chemoradiotherapy, which started with brachytherapy. Out of them, 54 have undergone radical hysterectomy with lymphadenectomy followed by chemoradiation. We have retrospectively analyzed the 5-year overall survival (OS) rates relative to the lymph node involvement, the type of lymphadenectomy performed (pelvic, para-aortic, or both), the size of the tumor (> or < 4 cm), the histological type, grading, and the age of patients.

We observed significant differences in the OS rates relative to the age of the patients with LACC. We noted significant differences in the OS rates related to para-aortic lymphadenectomy and presence of lymph node metastases.

Para-aortic lymphadenectomy seems to have a positive influence on long-term outcomes in the LACC patients, and elderly patients may benefit more from applied therapy.


brachytherapy, chemoradiotherapy, locally advanced cervical cancer, lymphadenectomy

Chantalat E, Vidal F, Leguevaque P et al. Cervical cancer with paraaortic involvement: do patients truly benefit from tailored chemoradiation therapy? A retrospective study on 8 French centers. Eur J Obstet Gynecol Reprod Biol 2015; 193: 118-122.
Chantalat E, Vidal F, Leguevaque P et al. Para-aortic workup in locally advanced cervical cancer: heterogeneity is still the rule. Results from a retrospective multicenter study. Arch Gynecol Obstet 2016; 293: 1081-1086.
Choi HJ, Roh JW, Seo SS et al. Comparison of the accuracy of magnetic resonance imaging and positron emission tomography/computed tomography in the presurgical detection of lymph node metastases in patients with uterine cervical carcinoma: a prospective study. Cancer 2006; 106: 914-922.
Margulies AL, Peres A, Barranger E et al. Selection of patients with advanced-stage cervical cancer for para-aortic lymphadenectomy in the era of PET/CT. Anticancer Res 2013; 33: 283-286.
Derks M, Biewenga P, van der Velden J et al. Results of radical surgery in women with stage IB2/IIA2 cervical cancer. Acta Obstet Gynecol Scand 2016; 95: 166-172.
Köhler C, Mustea A, Marnitz S et al. Perioperative morbidity and rate of upstaging after laparoscopic staging for patients with locally advanced cervical cancer: results of a prospective randomized trial. Am J Obstet Gynecol 2015; 213: 503.
Zanagnolo V, Minig L, Rollo D et al. Clinical and oncologic outcomes of robotic versus abdominal radical hysterectomy for women with cervical cancer: experience at a Referral Cancer Center. Int J Gynecol Cancer 2016; 26: 568-574.
Zhou G, Chen X, Tang F et al. The value of diffusion-weighted imaging in predicting the prognosis of stage IB-IIA cervical squamous cell carcinoma after radical hysterectomy. Int J Gynecol Cancer 2016; 26: 361-366.
Macdonald OK, Chen J, Dodson M et al. Prognostic significance of histology and positive lump node involvement following radical hysterectomy in carcinoma of the cervix. Am J Clin Oncol 2009; 32: 411-416.
Ouldamer L, Fichet-Djavadian S, Marret H et al. Upper margin of para-aortic lymphadenectomy in cervical cancer. Acta Obstet Gynecol Scand 2012; 91: 893-900.
Ouldamer L, Marret H, Acker O et al. Unusual localizations of sentinel lymph nodes in early stage cervical cancer: a review. Surg Oncol 2012; 21: e153-157.
Del Pino M, Fusté P, Pahisa J et al. Laparoscopic lymphadenectomy in advanced cervical cancer: prognostic and therapeutic value. Int J Gynecol Cancer 2013; 23: 1675-1683.
Zand B, Euscher ED, Soliman PT et al. Rate of para-aortic lymph node micrometastasis in patients with locally advanced cervical cancer. Gynecol Oncol 2010; 119: 422-435.
Goff BA, Muntz HG, Paley PJ et al. Impact of surgical staging in women with locally advanced cervical cancer. Gynecol Oncol 1999; 74: 436-442.
Leblanc E, Katdare N, Narducci F et al. Should systematic infrarenal para-aortic dissection be the rule in the pretherapeutic staging of primary or recurrent locally advanced cervix cancer patients with a negative preoperative para-aortic PET imaging? Int J Gynecol Cancer 2016; 26: 169-175.
Kang S, Kim YS, Choi HJ et al. Additional value of combined evaluation of tumor size with lymph node size in the detection of lymph node metastases in early-stage cervical cancer patients. J Comput Assist Tomogr 2013; 37: 572-576.
Gil-Moreno A, Magrina JF, Pérez-Benavente A et al. Location of aortic node metastases in locally advanced cervical cancer. Gynecol Oncol 2012; 125: 312-314.
Morice P, Castaigne D, Pautier P et al. Interest of pelvic and paraaortic lymphadenectomy in patients with stage IB and II cervical carcinoma. Gynecol Oncol 1999; 73: 106-110.
Cosin JA, Fowler JM, Chen MD et al. Pretreatment surgical staging of patients with cervical carcinoma: the case for lymph node debulking. Cancer 1998; 82: 2241-2248.
Leblanc E, Narducci F, Frumovitz M et al. Therapeutic value of pretherapeutic extraperitoneal laparoscopic staging of locally advanced cervical carcinoma. Gynecol Oncol 2007; 105: 304-311.
Zikan M, Fischerova D, Pinkavova I et al. A prospective study examining the incidence of asymptomatic and symptomatic lymphoceles following lymphadenectomy in patients with gynecological cancer. Gynecol Oncol 2015; 137: 291-298.
Lee JY, Kim Y, Lee TJ et al. Cost-effectiveness of para-aortic lymphadenectomy before chemoradiotherapy in locally advanced cervical cancer. J Gynecol Oncol 2015; 26: 171-178.
Lee JY, Kwon JS, Cohn DE et al. Treatment strategies for stage IB cervical cancer: A cost-effectiveness analysis from Korean, Canadian and U.S. perspectives. Gynecol Oncol 2016; 140: 83-89.
Vandeperre A, van Limbergen E, Leunen K et al. Para-aortic lymph node metastases in locally advanced cervical cancer: Comparison between surgical staging and imaging. Gynecol Oncol 2015; 138: 299-303.
Yildirim Y, Sehirali S, Avci ME et al. Integrated PET/CT for the evaluation of para-aortic nodal metastasis in locally advanced cervical cancer patients with negative conventional CT findings. Gynecol Oncol 2008; 108: 154-159.
Roh JW, Seo SS, Lee S et al. Role of positron emission tomography in pretreatment lymph node staging of uterine cervical cancer: a prospective surgicopathologic correlation study. Eur J Cancer 2005; 41: 2086-2092.
Frumovitz M, Querleu D, Gil-Moreno A et al. Lymphadenectomy in locally advanced cervical cancer study (LiLACS): Phase III clinical trial comparing surgical with radiologic staging in patients with stages IB2-IVA cervical cancer. J Minim Invasive Gynecol 2014; 21: 3-8.
Sharma C, Deutsch I, Horowitz DP et al. Patterns of care and treatment outcomes for elderly women with cervical cancer. Cancer 2012; 118: 3618-3626.
Cushman TR, Haque W, Menon H et al. Postoperative chemoradiotherapy versus radiotherapy alone for elderly cervical cancer patients with positive margins, lymph nodes, or parametrial invasion. J Gynecol Oncol 2018; 29: e97.
Chopra S, Gupta M, Mathew A et al. Locally advanced cervical cancer: A study of 5-year outcomes. Indian J Cancer 2018; 55: 45-49.
Quick links
© 2018 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe