Oncology and Fibroids
Mrs Shikha, 50-yrs-old woman is diagnosed with cervical cancer. Which lymph node group would be the first involved in metastatic spread of this disease beyond the cervix and uterus? (DNB June 2011)
|A||Common iliac nodes|
|C||External iliac nodes|
|D||Paracervical or ureteral nodes|
Paracervical or ureteral nodes
1. The main routes of spread of cervical cancer include vaginal mucosa, myometrium, paracervical lymphatics, and direct extension into the parametrium.
2. The prevalence of lymph node disease correlates with the stage of malignancy Primary node groups involved in the spread of cervical cancer include the paracervical, parametrial, obturator, hypogastric, external iliac, and sacral nodes, essentially in that order.
3. Less commonly, there is involvement in the common iliac, inguinal, and paraaortic nodes. In stage I, the pelvic nodes are positive in approximately 15% of cases and the paraaortic nodes in 6%. In stage II, pelvic nodes are positive in 28% of cases and paraaortic nodes in 16%.
4. In stage III, pelvic nodes are positive in 47% of cases and paraaortic nodes in 28%.