Surgical staging is done through an approach outside the lining of the abdominal cavity or occasionally via a laparoscope. This does not involve the manipulation of the intra-abdominal organs as much as an intra-abdominal operation and results in fewer complications following radiation therapy .
The incidence of cancerous pelvic and para-aortic nodes increases with more advanced disease and there may be a survival advantage to removing the involved nodes. About a third of the time, women with microscopic metastases to the pelvic and aortic nodes can be cured if the nodes are removed and radiation therapy is then given.
Women with positive para-aortic nodes may have distant metastases to the lymph nodes above the collarbone (10 to 20 percent of cases). If the neck nodes are positive, then only palliative therapy is warranted.
Radiation Several radiation techniques may be used depending on the stage of the disease—
external beam therapy or the insertion of radioactive substances into the cervix (intracavitary radiation) or into the tumor (interstitial radiation).
Women with metastatic cancer of the para-aortic lymph nodes are usually treated with external beam radiation.
