Scalene lymph node sampling in cervical carcinoma: a reappraisal.

Scalene lymph node sampling to detect occult metastases from cervical carcinoma has been reported to have varying degrees of clinical utility. During the past 7 years at the Los Angeles County University of Southern California Medical Center, 17 scalene lymph node samplings were performed in patients with clinical stage IB to IIIB cervical carcinoma who had metastases to the paraaortic lymph nodes, negative chest X ray, and no clinical evidence of scalene/supraclavicular node metastases. Four of the patients were demonstrated on microscopic examination to have scalene lymph node metastases (23.5%). There were no serious complications related to this surgery. Patients with cervical carcinoma whose only extra pelvic site of metastases is the paraaortic modes should be considered for scalene lymph node sampling as part of their pretreatment evaluation, especially if extended-field radiation is contemplated.