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 para-aortic area.

Uzan, Catherine; Souadka, A.; Gouy, Sébastien; Debaere, Thierry; Duclos, J.; Lumbroso, J.; Meder, Christine; Morice, Philippe

doi:10.1200/jco.2011.29.15_suppl.e15574

Cited by 15 publications

(23 citation statements)

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“…11,17,27 In retrospective series, the mean waiting time before RCTX after paraaortic surgical staging varies between 10 and 35 days. 9,12,14,27,40,41 In our prospective, randomized, multicenter trial, this parameter (13 days) also met the recommended interval. This question is one the most controversial oncological issues in the treatment of patients with locally advanced cervical cancer.…”

Section: Commentmentioning

confidence: 68%

Perioperative morbidity and rate of upstaging after laparoscopic staging for patients with locally advanced cervical cancer: results of a prospective randomized trial

Köhler

Mustea

Marnitz

et al. 2015

American Journal of Obstetrics and Gynecology

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Section: Commentmentioning

confidence: 68%

Perioperative morbidity and rate of upstaging after laparoscopic staging for patients with locally advanced cervical cancer: results of a prospective randomized trial

Köhler

Mustea

Marnitz

et al. 2015

American Journal of Obstetrics and Gynecology

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“…Uzan et al [14] did not find any significant delay of the radiochemotherapy due to surgical staging complications. In our series, the 9.3% complications rate was similar to the other studies.…”

Section: Discussionmentioning

confidence: 99%

Lack of Survival Benefit of Para-Aortic Lymphadenectomy in Advanced Cervical Cancer

González-Benítez

Salas

Grabowski

et al. 2019

Gynecol Obstet Invest

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Introduction: The presence of positive para-aortic lymph nodes in advanced cervical cancer remains the most important prognostic factor for survival and also defines the treatment. Our aim was to define the influence of staging para-aortic lymphadenectomy in patients’ survival. Material and Methods: The medical records of 74 patients with advanced cervical cancer (FIGO IIB-IVA) were reviewed. In 31 patients (41.9%), the assessment of lymph nodes was performed with imaging test (group 1) and in 43 (58.1%) within a surgical staging para-aortic lymphadenectomy (group 2). We compared both groups according to stage of disease, treatment, progression-free survival (PFS), and overall survival (OS). Results: The extended-field radiotherapy was performed in 44.2 and 19.4% of patients in surgical and imaging staging group, respectively (p = 0.045). The disease-free survival rate was 17.4 ± 17.4 months in group 1 and 14.4 ± 12.6 months in group 2 (p = 0.456). No differences in OS were found between these 2 groups (p = 0.676). Conclusions: Despite the higher diagnostic accuracy of surgical staging and the higher number of patient who received extended field radiotherapy, we did not find differences between the overall and PFS rates in both the studied groups. Further prospective study on a higher number of patients would be necessary.

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“…According to Uzan et al [36], surgical staging could be acceptable if there is a risk of less than 4-5% of severe morbidity, defined as a morbidity that delays the start of CRT more than 30-45 days from diagnosis [8,37]. To guarantee this acceptable morbidity rate, surgery should be performed by a trained team in a referral gynaecologic oncology centre and possibly with minimally invasive surgical techniques.…”

Section: Discussionmentioning

confidence: 99%

Locally Advanced Cervical Cancer: Is a Trimodality Treatment a Safe and Effective Approach?

et al. 2018

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Background: Chemoradiotherapy (CRT) is the standard of care for locally advanced cervical cancer (LACC). Pre-treatment lymph nodes (LN) assessment may have an important therapeutic role. CRT followed by adjuvant chemotherapy increased progression free survival (PFS) and overall survival (OS). Our study evaluated the feasibility and the effectiveness of a trimodality strategy in patients with LACC and positive LN. Methods: Consecutive patients with LACC treated at the National Cancer Institute of Milan were enrolled. All patients underwent pelvic and para-aortic extraperitoneal laparoscopic lymphadenectomy to assess the nodal status. After surgery, patients received radiotherapy followed by chemotherapy according to the stage of disease. Results: Between April 2012 and October 2013, 19 cervical cancer patients were enrolled. Overall, 10 (52.6%) patients presented with positive LN: 6 in the pelvic area and 4 both in the pelvic and para-aortic area. No perioperative major complications occurred. The most common surgical-related adverse events were bleeding (26%), respiratory distress (5%), infection (5%) and the development of lymphoceles (25%). Overall, 15 (78.9%) complete responses and 2 (10.5%) partial responses were registered. After a median follow-up of 43.3 months, 89.5% of patients were alive at the last visit, and 3-year PFS was 63%. Conclusions: Trimodality treatment appears feasible, well tolerated and promising in terms of oncologic outcome.

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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 para-aortic area.

Cited by 15 publications

References 0 publications

Perioperative morbidity and rate of upstaging after laparoscopic staging for patients with locally advanced cervical cancer: results of a prospective randomized trial

Perioperative morbidity and rate of upstaging after laparoscopic staging for patients with locally advanced cervical cancer: results of a prospective randomized trial

Lack of Survival Benefit of Para-Aortic Lymphadenectomy in Advanced Cervical Cancer

Locally Advanced Cervical Cancer: Is a Trimodality Treatment a Safe and Effective Approach?

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