Para-aortic lymph node biopsy before radical hysterectomy in early carcinoma of the cervix

SummaryIn a series of 150 consecutive patients with stage 1b or 2a carcinoma of the cervix, para-aortic lymph node biopsy with a frozen section was performed at the start of radical hysterectomy. The frozen section was positive in ten of 11 patients in whom the para-aortic nodes were eventually found to be positive on paraffin section. There were no false positives on frozen section but one false negative. There were four injuries to the vena cava, three of which required suture. In ten cases the operation was modified in some way as a result of the knowledge of the aortic lymph node status. Despite postoperative pelvic irradiation in ten cases and combination chemotherapy in one case, eight of the 11 patients died of their disease within 2 years of surgery and three are alive, having survived 3, 4 and 6 months, respectively. Operative removal of the uterus and parametria in all but one case prevented central pelvic recurrence although five patients developed lateral pelvic wall recurrence.