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Radiation Oncology • Gynecologic Cancers
Do you consider high para-aortic nodes above the renal vessels to be locally advanced or metastatic in cervical cancer?
For a patient with a very locally advanced cervical cancer, what is your upper/superior limit of considering para-aortic lymph nodes to be "pelvic" or regional?
Answer from: Radiation Oncologist at Community Practice
It sounds like you are asking how aggressively to treat patients with para-aortic nodal spread. My limit for "para-aortic" or "regional LAD" is usually anything below the diaphragm. I generally think of and treat these patients as advanced stage III.I would also advocate for definitively treating ce...
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Answer from: Radiation Oncologist at Community Practice
After renal vessel, the next cranial level is retrocrural nodes. I do treat definitively but warn the patient about the very high risk of distant in future. Also at that level, I contour retrocrural space and not celiac nodes to limit exposure of OAR.Kabolizadeh et al., PMID 23849691.When treating t...