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The PALNs were classified as left-lateral para-aortic (LPA), aorto-caval (AC), and right para-caval (RPC). Four PA CTVs were contoured for each patient to validate PALN coverage. CTV\n                      <jats:sub>RTOG<\/jats:sub>\n                      was contoured based on the Radiation Therapy Oncology Group guideline. CTV\n                      <jats:sub>K<\/jats:sub>\n                      was contoured as proposed by Keenan et al. CTV\n                      <jats:sub>M<\/jats:sub>\n                      was contoured by expanding symmetrical margins around the aorta and inferior vena cava of 7\u00a0mm up to the T12\u2013L1 interspace. CTV\n                      <jats:sub>new<\/jats:sub>\n                      was created by modifying CTV\n                      <jats:sub>RTOG<\/jats:sub>\n                      to obtain better coverage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified 92 PALNs in 35 cervical cancer patients. 46.8% of the PALNs were at LPA, 38.0% were at AC, and 15.2% were at RPC areas. CTV\n                      <jats:sub>RTOG<\/jats:sub>\n                      , CTV\n                      <jats:sub>K<\/jats:sub>\n                      , and CTV\n                      <jats:sub>M<\/jats:sub>\n                      covered 87.0%, 88.0%, and 62.0% of all PALNs, respectively. PALN recurrence above the left renal vein was associated with PALN involvement at diagnosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043). Extending upper border to the superior mesenteric artery allowed the CTV\n                      <jats:sub>new<\/jats:sub>\n                      to cover 96.7% of all PALNs and all nodes in 91.4% of patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      CTV\n                      <jats:sub>RTOG<\/jats:sub>\n                      and CTV\n                      <jats:sub>K<\/jats:sub>\n                      encompassed most PALN recurrences. For high-risk patients, such as those having PALN involvement at diagnosis, extending the superior border of CTV from the left renal vein to superior mesenteric artery could be considered.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13014-021-01856-9","type":"journal-article","created":{"date-parts":[[2021,7,10]],"date-time":"2021-07-10T06:02:44Z","timestamp":1625896964000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Mapping patterns of para-aortic lymph node recurrence in cervical cancer: a retrospective cohort analysis"],"prefix":"10.1186","volume":"16","author":[{"given":"Bong Kyung","family":"Bae","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0291-8985","authenticated-orcid":false,"given":"Shin-Hyung","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin Young","family":"Jeong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gun Oh","family":"Chong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mi Young","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Chul","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,7,10]]},"reference":[{"issue":"15","key":"1856_CR1","doi-asserted-by":"publisher","first-page":"1144","DOI":"10.1056\/NEJM199904153401502","volume":"340","author":"PG Rose","year":"1999","unstructured":"Rose PG, Bundy BN, Watkins EB, Thigpen JT, Deppe G, Maiman MA, et al. 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