The importance of parametrial lymph nodes in the treatment of cervical cancer

Early cervical carcinoma

“…17 The lateral trunk runs through the lateral parametrium and is the main lymphatic drainage from the uterine cervix. As already described by Girardi et al, 13 we showed that there are many lymph nodes in both the inner and outer part of the lateral parametrium as well as lymphatic vessels, both of which can be potential metastatic sites. The anterior lymphatic trunk runs through the vesicouterine ligament toward the interiliac lymph nodes.…”

“…The first is that parametrial lymph nodes were detected in Ͼ 90% of the patients, which is a higher rate than that reported previously, 12,13 suggesting that these lymph nodes are present in nearly all women. The lymph nodes were observed in the cardinal ligament, in both layers of the cervicovesical ligament, and, albeit less frequently, in the sacrouterine ligament.…”

An easier ureteral tunnel approach during laparoscopic-assisted radical vaginal hysterectomy

“…The paraaortic lymph nodes are removed when frozen sections show pelvic node involvement. The rationale is that metastatic extension to the paraaortic nodes is less than 1-2% when pelvic nodes are free of disease [6][7][8][9].…”

Fertility preserving treatments in different prognostic groups of cervical cancer patients

“…It has been several times demonstrated, that the location of parametrial metastases in surgical specimens being randomly distributed with an equal number of metastatic foci in the lateral and medial parametria. 39 Detailed analysis of pelvic Nonrandomized retrospective studies demonstrated that adjuvant radiotherapy after radical hysterectomy decreased the risk of pelvic recurrence but did not improve the overall survival in high and intermediate-risk cervical cancer. 83 Based on these data, we presumed that survival of surgically treated patients with cervical cancer might be improved by stringent complete removal of the parametria, which contains lymphatic nodes and vessels.…”

“…Incomplete removal of the lateral parametria where random metastases have been demonstrated histologically could be the reason of high failure rate in larger tumors. 39,40 In addition, learning the vaginal radical procedure can be difficult due to the limited access to the operative field for teaching and the low number of suitable candidates in individual centers. …”