Impact of the Number of Positive Pelvic Lymph Nodes on Risk of Para-Aortic Recurrence in Patients with Clinically Early Cervical Cancer Treated by a Radical Hysterectomy and Pelvic Lymphadenectomy.

Background: Guidelines recommend the extension of the pelvic radiotherapy volume to the para-aortic region in locally advanced cervical cancer and ≥3 suspicious pelvic lymph nodes (PLN) on imaging. Whether this recommendation is also valid for clinically early stages is uncertain. The objective of this study was to investigate the para-aortic (PAO) lymph node recurrence rate in patients with early-stage cervical cancer, ≥3 metastatic PLN, and negative common iliac nodes after a radical hysterectomy followed by pelvic (chemo)radiotherapy without extension to the PAO region.