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[The treatment of lymph nodes metastases of stage I and II cervical carcinoma].

OBJECTIVE
To investigate the treatment methods of nodal metastases of stages I and II cervical carcinoma.


METHODS
Surgical data of 84 patients with stages I and II cervical carcinoma were analyzed. All patients underwent extensive abdominal hysterectomy and bilateral pelvic lymphadenectomy, 18 of whom received systematic resection of periaortic metastatic lesions. The method of isolation of the ureters from lateral exterior were performed on 45 patients. Wertheim-Meigs' operation was performed in 39 patients and preoperative lymphangiography and dyeing in 40 patients, followed by radiotherapy and chemotherapy.


RESULTS
77 cases were followed up for more than five years, 55 (71.4%) were alive. In the patients with one node involved, the survival rate was 85.7%, and in those with two or more nodes involved it was 63.3%. The survival rate of the lymphangiography group was 80.0%, and that of the control group 62.2%. The recurrent rate of cardinal ligament nodes was 2.2% in the patients with lateral isolation of the ureters and was 17.9% in the Wertheim-Meigs' group. The survival rate of patients with periaortic metastasis was 52.9%.


CONCLUSIONS
Lateral isolation of the ureters and resection of cardinal ligaments with their lymph nodes preoperative lymphangiography and dyeing, and resection of periaortic metastatic nodes could reduce nodal recurrence and raise the five year survival rate.