Para-aortic lymph node (PALN) dissection is optional and controversial in patients with stage IB1-IIA2
cervical cancer. This retrospective study investigated PALN involvement patterns and evaluated preoperative clinical factors. A total of 723 consecutive FIGO stage IB1-IIA2
cervical cancer patients were included in the study. All patients underwent radical
hysterectomy/radical
trachelectomy, pelvic
lymph node dissection, and PALN dissection. PALN
metastasis was found in 101 (14.0%) patients, and the positive PALN rates of stage IB1, IB2, IIA1, and IIA2 were 8.4%, 11.1%, 17.2% and 21.7%, respectively. A multivariate model suggested age > 46 years (OR: 1.67, 95% confidence interval (CI): 1.08-2.58),
tumor size > 3.5 cm (OR: 1.79, 95% CI: 1.12-2.87), and FIGO stage IIA (vs. IB) (OR: 1.97, 95% CI: 1.25-3.11) all positively correlated with PALN
metastasis. When squamous
cervical cancer cases were categorically analyzed, a multivariate model indicated age > 46 years (OR: 1.67, 95% CI: 1.00-2.80), FIGO stage IIA (vs. IB) (OR: 1.76, 95% CI: 1.02-3.02), and
squamous cell carcinoma antigen (SCCA) > 6.5 ng/ml (OR: 5.20, 95% CI: 3.07-8.81) all positively correlated with PALN
metastasis. Age,
tumor size, and FIGO stage correlated with PALN
metastasis in
cervical cancer, while age, FIGO stage, and SCCA level were predictive in
squamous cell carcinoma.