Stage IB carcinoma of the cervix, the Norwegian Radium hospital. II. Results when pelvic nodes are involved.

From 1967 through 1972, 562 patients with squamous cell carcinoma of the cervix, stage IB (FIGO), underwent radical hysterectomy with pelvic lymphadenectomy. The patients with pelvic metastases were treated with external beam supervoltage irradiation of 4000 or 5000 rads to the pelvis. Metastases in the pelvic lymph nodes were found in 21.3%. In this study the authors analyzed in detail which nodes were involved with metastases and the relationship with survival and with recurrence. The overall 5-year survival for patients with pelvic lymph node metastases was 53%; for patients without metastases it was 92%. The site of recurrence in patients without demonstrable pelvic lymph node metastases was also examined. The main conclusion drawn from the study is that patients with pelvic node metastases below the common iliac group have a much better prognosis than patients in whom metastases are located in the common iliac nodes; in addition, when nodal involvement is below the common iliac level, patients with disease limited to one node or one group of nodes do not have a better prognosis than patients with multiple metastatic nodes.