Prognosis of the Patients Showing Metastasis to the Para-aortic or/and Supraclavicular Lymph Nodes at the Time of Diagnosis of Recurrence of the Cervical Cancer

Choi, Suk Chul; Kim, Byoung Sub; Jeon, Young Sook; Kim, Byoung Taek; Lee, Kyung Hwa; Kim, Joung Hoon; Kim, Byoung Gie; Park, Sang Yoon; Lee, Eui Don; Lee, Kyung Hee; Park, Kee Bock

Abstract

This study was performed to evaluate the survival of the patients found to have metastasis only to the para-aortic or/and supraclavicular lymph nodes at the time of diagnosis of recurrence of the cervical cancer. In addition, the survival was compared between the patients metastasis limited to the para aortic or/and supraclavicular lymph nodes only and those having other concurrent metastatic sites. From Jan. 1991 to Dec. 1995, total 105 patients were identified to have metastasis of para-aortic or/and supraclavicular lymph nodes by computerized tomography(CT) scan or/and percutaneous needle aspiration cytology. Their medical records and cytologic slides were reviewed. The information about survival and disease status was obtained from the last follow-up date in medical records or from interview via telephone. Forty-one(39%) patie-nts showed para-aortic node metastasis: 23 patients(22%), supraclavicular node metastasis; 41(39%) patients, para-aortic and supraclavicular lymph node metastasis. Thirty-one(76%) of 41 patients involving para-aortic lymph node metastasis showed recurrent disease limited to the lymph nodes only: Eight(35%) of 23 patients with supraclavicular lymph node metastasis and sixteen(39%) of 41 patients with both lymph nodes metastasis showed lymph node metastasis only. Supraclavicular lymph node metastasis was found concurrently in 41(50%) of 82 patients with para-aortic lymph node metastasis at the time of recurrence. Forty-two patients(40 %) had been found to have previous pelvic lymph node metastasis at the time of initial treatm ent of the cervical cancer. The 3-year survival was 13.9% in patients with para-aortic lymph node metastasis: 0% with supraclavicular lymph node metastasis: 20.3% in para-aortic and supraclavicular lymph node metastasis. In addition, 3-year survival rate was not significantly different among the groups with different lymph node metastasis. Furthermore, there was no difference in the 3-year survival rate between the patients with lymph node metastasis only and those with other concurrent metastatic sites. These results showed that survival of the patients with metastasis to para-aortic or/and supraclavicular lymph nodes only at the time of diagnosis of recurrent cervical cancer may be still poor and was not different compara to that of the patients with other concurrent sites of metastasis.