PARAAORTIC LYMPH-NODE EVALUATION IN CERVICAL-CANCER - THE IMPACT OF STAGING UPON TREATMENT DECISIONS AND OUTCOME

This article reviews both surgical and nonsurgical staging options for cervical cancer and determines the ultimate impact of these staging p athways. Surgical staging is the most sensitive method, for detecting paraaortic lymph node metastases; however, a negative lymphangiogram p recludes surgical staging since it is a highly sensitive and specific radiographic study. CT and MRI are not as sensitive for detecting para aortic disease, therefore a false negative study would ultimately resu lt in the loss of about 4 stage IIB and 5 stage IIIB patients out of 1 00. Judicious use of existing staging options will enhance the ultimat e benefit to individual patients, rather than surgically staging all p atients prior to radiotherapy.