Five-year survival (with no evidence of disease) in patients with biopsy-confirmed aortic node metastasis from cervical carcinoma.

Thirty-one women with biopsy-confirmed aortic node metastases from carcinoma of the uterine cervix were treated with pelvic and para-aortic irradiation. The intestinal complication rate in those patients who received 6,000 rads of split-course irradiation in 8 weeks was 61.9% and only 10.0% in the patients who received primarily 4,400 to 5,000 rads in 4 1/2 to 5 weeks. The 5 year survival rate with no evidence of disease (NED) was only 9.6%, with death rates of 16.1% from complications NED and 74.1% from cancer. Of the nine women with microscopic evidence of aortic node metastasis in clinically negative aortic nodes, two are surviving NED after 5 years and seven have died. Six women had a single, clinically positive aortic node metastasis, and one patient is alive after 5 years NED and five are dead. All 16 women with multiple aortic node metastases died of cervical cancer, including six patients who had 100% resection of the multiple para-aortic node metastases. A plan of management for surgical staging and para-aortic irradiation is outlined.