Analysis of Morbidity and Clinical Implications of Laparoscopic Para-Aortic Lymphadenectomy in a Continuous Series of 98 Patients with Advanced-Stage Cervical Cancer and Negative PET–CT Imaging in the Para-Aortic Area

Abstract

Background. Laparoscopic para-aortic lymphadenectomy (PAL) is being used increasingly to stage patients with locally advanced cervical cancer (LACC) and to define radiation field limits before chemoradiation therapy (CRT). This study aimed to define clinical implications, review complications, and determine whether surgical complications delayed the start of CRT.Methods. We retrospectively reviewed a continuous series of patients with LACC, with no positive paraaortic (PA) nodes on positron emission tomographycomputed tomography (PET-CT) and who had undergone a primary laparoscopic PAL.Results. From

Should Systematic Infrarenal Para-aortic Dissection Be the Rule in the Pretherapeutic Staging of Primary or Recurrent Locally Advanced Cervix Cancer Patients With a Negative Preoperative Para-aortic PET Imaging?

“…18,33 To assess all abovementioned aspects, we performed this prospective study to see whether we can limit the level of dissection to the inframesenteric level in a group of LACC patients selected on PET-CT results.…”

Lymphadenectomy in Locally Advanced Cervical Cancer Study (LiLACS): Phase III Clinical Trial Comparing Surgical With Radiologic Staging in Patients With Stages IB2–IVA Cervical Cancer

“…Two recent phase II studies have further evaluated the sensitivity of FDG-PET/CT in the detection of pathologically positive paraaortic nodes [9, 10]. In these studies, all patients had stages IB2-IVA cervical cancer and underwent PET/CT followed by surgical staging via removal of the paraaortic nodes utilizing a laparoscopic extraperitoneal approach.…”

Maximum Standardized Uptake Value of Pelvic Lymph Nodes in [18F]-Fluorodeoxyglucose Positron Emission Tomography Is a Prognostic Factor for Para-Aortic Lymph Node Recurrence in Pelvic Node–Positive Cervical Cancer Treated With Definitive Chemoradiotherapy

“…Under these circumstances, FDG PET scan can be used as an alternative approach to detect PALN metastasis due to its false-negative rate of 8.4%. 15 In this study, greater reliability was achieved through the use of FDG PET in pretreatment and follow-up evaluation for all patients. The 5-year PALN recurrence rate was reported to be 7% after pelvic CCRT.…”