••• Chapter 43^ Cervical Lesions and Cancer^437
❍ What is the incidence of para-aortic lymph node metastasis for stage IIB and III disease?
Approximately 19% and 30%, respectively.
❍ What is the 5-year survival for stage IIB and III disease?
Approximately 65% and 45%, respectively.
❍ What is the most common site of distant metastases of cervical cancer?
Lung. Twenty-one percent of distant metastases of cervical cancer are found in the lung.
❍ What are the usual borders used for whole pelvic external beam radiation therapy?
- Superiorly, the midvertebral level of L5.
- Inferiorly, the inferior aspect of the obturator foramina or at least 2 cm below the most distal vaginal tumor.
- Laterally, 1 cm lateral to the margins of the bony pelvis.
❍ How is the external beam treatment field altered when the para-aortic nodes are included?
A 10 cm wide portal extends from the pelvic field up to the T12-L1 interspace.
❍ What percentage of cervical cancers occur in women during reproductive years?
10% to 15%.
❍ What is the incidence of cervical cancer during pregnancy?
Approximately 1.2 per 10,000 pregnancies.
❍ What is the most frequent female genital cancer during pregnancy?
Cervical cancer.
❍ How does pregnancy affect survival for patients with cervical cancer?
When prognostic factors are controlled for, survival is not affected by pregnancy.
❍ What is the incidence of supraclavicular lymph node involvement when the para-aortic nodes contain
metastatic disease?
5% to 30%. The left side is more commonly involved (entry of portal for the thoracic duct).
❍ What percentage of cervical cancer recurrences will be detected within 1, 2, and 5 years of follow-up?
50% of recurrences will be detected within the first year, 75% within 2 years, and 95% within 5 years.
❍ How do survival rates of patients with adenocarcinoma of the cervix compare with those of squamous cell
carcinoma?
Controlling for prognostic factors such as stage, volume of disease, and lymph node metastasis and survival appears
to be similar.