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Acta Obstet Gynecol Scand. 2012 Aug;91(8):893-900. doi: 10.1111/j.1600-0412.2012.01443.x. Epub 2012 Jun 15.

Upper margin of para-aortic lymphadenectomy in cervical cancer.

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  • 1Department of Gynecology, François-Rabelais University, Tours, France.


Patients with early stage cervical cancer routinely undergo pelvic lymphadenectomy. A para-aortic lymphadenectomy is only performed in the setting of grossly enlarged lymph nodes. In patients with locally advanced disease, a para-aortic lymphadenectomy is indicated particularly when pelvic nodes are suspicious for disease on preoperative imaging. There is no consensus about the extent of para-aortic lymph node dissection in these patients. We reviewed relevant literature to determine the extension of para-aortic lymphadenectomy in patients with cervical cancer in order to establish whether lymph node dissection up to the inferior mesenteric artery or higher to the level of renal vessels should be performed. We performed a systematic search (PubMed; up to June 2011) to review systematic complete para-aortic lymphadenectomy. According to our search, eight women (1.09%) had isolated para-aortic node metastases, of which two had only lymph node metastases above the inferior mesenteric artery.

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