Which nodes are affected by carcinoma in the upper one-third of the vagina?

In the context of carcinoma in the upper one-third of the vagina, the primary drainage occurs through the iliac nodes. Specifically, the upper vagina is primarily drained by the internal and external iliac lymph nodes. This anatomical pathway is crucial because lymphatic drainage patterns influence the assessment of metastatic spread in cancer cases.

Understanding the lymphatic drainage is essential for staging the cancer and guiding treatment options. While inguinal nodes can be affected in cancers of the lower vagina (where lymphatic drainage goes more superficially), they are not the primary nodes of concern for carcinomas of the upper one-third. Similarly, cervical nodes are more directly involved with the cervix and lower vagina, while lumbar nodes do not relate to the lymphatic drainage pathways of the vagina.

Thus, identifying the iliac nodes as the correct answer highlights the significance of anatomical relationships in lymphatic drainage and their clinical relevance in the management of vaginal carcinoma.