gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

Pathways of Lymphogenic Spread of Cervical Cancer in Stage IB and IIA


Author(s): Ryszard Poręba, Janusz Pozowski

Introduction. Cervical cancer is 2nd sex related malignancy in women in Poland, right after breast cancer according to their incidence. It spreads mainly through lymphatic vessels of parametria to pelvic, then paraaortic lymph nodes. Steps of the spread are copied in the handbooks of oncologic gynecology, though histological reports are often surprising for clinicians. Objectives. The aim of our study is analysis of the lymphogenic spread in stages IB and IIA of cervical cancer. Material and method. 68 women with cervical cancer in stage IB or IIA operated on with Wertheim-Meigs technique in our Dept. of Gynecology and Obstetrics were analysed. The analysis involved subsequent groups on both sides of lymph nodes: iliac arteries bifurcation, external iliac in superior and inferior part separately, internal iliac, lacuna vasorum (Rosenmueller’s node), obturatory fossa, common iliac, paraaortic. The collected material was examined under microscopic magnification, macroscopically suspected nodes were previously marked. The results of histologic examination were put on the map of lymphatic drainage on pelvis, general quantity of the nodes and number of the metastatic ones was also noted. Individual pathway of spread was thus created. Results. The metastases were found in total amount of 88 lymph nodes, 23 were bilateral. Most common location for metastases in stage IB or IIA was iliac bifurcation – 29(26,2%), then external iliac -21(18,9%), internal iliac -21(18,9%) and common iliac -21(18,9%). Conclusions. Exact mapping of the collected lymph nodes allows for individual analysis in each case and is important for further treatment