Is positive pelvic lymphadenopathy a contraindication to radical surgery in recurrent cervical carcinoma?

The extent of disease at the time of surgical exploration determines whether radical surgery can be performed in the patient who has a postirradiation cervical cancer recurrence. Contraindications to extirpative surgery includes spread of disease beyond the confines of the removable organs. This includes common iliac and periaortic lymph node metastasis. Some authors have advocated aborting the procedure when pelvic nodes are involved. In a review of 170 patients undergoing radical surgery for cervical cancer recurrence, 25 percent with positive nodes survived 5-yr compared with 36 percent with negative nodes. The finding of positive pelvic lymph nodes in itself should not be the sole reason for abandoning the operative procedure.