Objectives The general objective of this study was to evaluate the management of the paraaortic lymph node region in patients with locally advanced cervical cancer for definitive EBRT with concurrent chemotherapy.

Methods Records of patients with cervical cancer treated with definitive EBRT with concurrent chemotherapy from 2017–2019 were retrospectively reviewed, and relevant data were tabulated.

Results A total of 150 patient records were reviewed. Survival outcomes were available for 77 patients; 31 were treated with EFRT and 46 were treated with Pelvic EBRT. Patients were more likely to receive EFRT if they were staged as having more advanced (> Stage IIIB) disease, or if there was note of enlarged (> 1.0 cm) pelvic nodes (P=0.004), > 3 pelvic nodes (P<0.001), or involved common iliac (P<0.001), external iliac (P<0.001), internal iliac (P<0.001), or obturator (P=0.019) nodes, or prominent or enlarged paraaortic nodes at the time of CT-simulation (P<0.001). After a median follow-up of 11.3 months, there was no significant difference observed in terms of pelvic recurrence-free survival (77.4% vs 80.4%; P=1.000), paraaortic recurrence-free survival (936% vs 89.1%; P=0.95), distant metastasis-free survival (77.4% vs 80.4%; P=0.780) and disease-free survival (61.3% vs 69.6%; P=0.472) between patients receiving EFRT versus Pelvic EBRT. The presence of enlarged (> 1.0 cm) paraaortic lymph nodes during CT-simulation was independently associated with inferior disease-free survival (OR 8.45 [1.48 to 48.26]; P=0.016).

Conclusions Comparable survival outcomes were observed between cervical cancer patients receiving EFRT and Pelvic EBRT. Patients presenting with enlarged paraaortic nodes were found to have inferior disease-free survival despite having received EFRT.