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Management of Para-aortic Lymph Node Disease in Patients With Cervical Cancer: What Is the Best Approach?
  1. Marcelo Vailati Negrão, MD,
  2. Julianne Maria da Silva Lima, MD,
  3. Samantha Cabral Severino Silva, MD,
  4. Maria Del Pilar Estevez Diz, MD, PhD and
  5. Vanessa da Costa Miranda, MD
  1. Department of Medical Oncology, Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
  1. Address correspondence and reprint requests to Marcelo Vailati Negrão, MD, Department of Medical Oncology, Instituto do Câncer do Estado de São Paulo, Faculdade de Medicina da Universidade de São Paulo, Avenida Dr Arnaldo, 251, Cerqueira Cesar, ZIP code 01246–000, São Paulo, Brazil. E-mail: mvnegrao@gmail.com.

Abstract

Abstract Cervical cancer remains a prevalent and deadly disease in low-income countries, especially among young and otherwise healthy women. Multimodality treatment has led to a significant improvement in outcomes for patients with locally advanced disease, and this is mainly because of the incorporation of platinum-based chemoradiotherapy in current treatment protocols. However, locally advanced tumors are associated with a greater risk for para-aortic lymph node (PALN) involvement, which is an important adverse prognostic factor. Most staging techniques have low accuracy for detection of disease in this area, which could lead to understaging and undertreatment. Meanwhile, patients with PALN disease are underrepresented in trials addressing the treatment of advanced cervical cancer and a few studies have been directed at this population. The aim of this review is to analyze the current data regarding staging and treatment of cervical cancer with PALN disease to determine which strategy is best when managing these patients.

  • Cervical cancer
  • Para-aortic
  • Lymph nodes
  • Diagnosis
  • Treatment
  • Toxicity

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Footnotes

  • All authors worked on the conception and design of the article, the collection, assembly, analysis, and interpretation of data, and the writing and final approval of the manuscript.

  • The authors declare no conflicts of interest.

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