Exploratory celiotomy for surgical staging of cervical cancer

Averette, Hervy E.; Dudan, Ronald C.; Ford, John H.

doi:10.1016/0002-9378(72)90741-7

Cited by 123 publications

(19 citation statements)

References 6 publications

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“…19 LN status is reported to be one of the most important factors for recurrence and survival in cervical cancer. 20,21 MRI is limited in differentiating metastatic lymphadenopathy from reactive LN hyperplasia. 22 Although PET has revealed 85.7% sensitivity, 94.4% specificity, 92% accuracy in locally advanced cervical cancer, 23 sensitivity is limited to 10% (1/10) in cases without LN enlargement on the MRI.…”

Section: Discussionmentioning

confidence: 99%

Experiences of pretreatment laparoscopic surgical staging in patients with locally advanced cervical cancer: results of a prospective study

et al. 2008

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Objective: To prospectively evaluate the feasibility, safety, and survival of laparoscopic surgical staging in patients with locally advanced cervical cancer. Methods: From Oct 2001 to Jul 2006, a total of 83 consecutive patients were eligible for inclusion and underwent laparoscopic surgical staging. Results: Three patients with intraoperative great vessel injury and 1 patient in whom the colpotomizer was unable to be inserted were excluded. Laparoscopic surgical staging was feasible in 95.2% (79/83). Immediate postoperative complications were noted in 12 (15.2%) patients. Prolonged complications directly related to operative procedures numbered 2 (2.5%), and were trocar site metastases. The mean time from surgery to the start of radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) was 11 (5-35) days. All patients tolerated the treatment well and completed scheduled RT or CCRT without disruption of treatment and additional admission. The rate of modification of the radiation field after surgical staging was 8.9% (7/79). Five-year progression-free survival and overall survival (OS) rates were 79% and 89%, respectively. The OS of patients with microscopic lymph node metastases, which were fully resected, were comparable to those of patients without lymph node metastasis. However, the OS of patients with macroscopic lymph node metastases that were fully resected were poorer compared with those of patients without lymph node metastasis. Conclusion: Pretreatment laparoscopic surgical staging is a feasible and safe treatment modality. However the survival benefit of debulking lymph nodes or full lymph node dissection is not clear.

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Section: Discussionmentioning

confidence: 99%

Experiences of pretreatment laparoscopic surgical staging in patients with locally advanced cervical cancer: results of a prospective study

et al. 2008

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“…Clinical staging of cervical cancers is accurate in only approximately 60% of cases, which is far less than surgical staging accuracy [2,3]. Lymph node metastasis is not a factor for FIGO staging; however, nodal metastases in gynecologic malignancies have an adverse impact on survival, especially in cases of paraaortic node involvement in cervical cancer [4,5].…”

Section: Webmentioning

confidence: 99%

MRI for Pretreatment Lymph Node Staging in Uterine Cervical Cancer

Choi

Kim

Seo

et al. 2006

American Journal of Roentgenology

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WEBThis is a Web exclusive article.OBJECTIVE. The purpose of this article is to assess the accuracy of MRI in detecting pelvic and paraaortic lymph node metastasis from uterine cervical cancer using various imaging criteria.CONCLUSION. Although MRI analysis resulted in relatively low sensitivity, size and margin (spiculated or lobulated) were useful criteria for predicting lymph node metastasis from cervical cancer.ervical cancer is the second most frequently diagnosed malignancy in women worldwide, and it is the only major gynecologic malignancy clinically staged according to International Federation of Obstetrics and Gynecology (FIGO) recommendations [1]. Clinical staging of cervical cancers is accurate in only approximately 60% of cases, which is far less than surgical staging accuracy [2,3]. Lymph node metastasis is not a factor for FIGO staging; however, nodal metastases in gynecologic malignancies have an adverse impact on survival, especially in cases of paraaortic node involvement in cervical cancer [4,5]. Although nodal resection before radiation therapy results in a higher survival rate in patients with grossly enlarged pelvic and paraaortic lymph nodes [6,7], routine pretreatment surgical staging is not recommended. For this reason, inaccurate pretreatment assessment of lymph node involvement can lead to suboptimal treatment [8,9].CT and MRI have been used to assess paraaortic and pelvic lymph nodes in patients with cervical cancer. A meta-analysis of such studies concluded that these methods have only moderate sensitivity and specificity for detecting metastases [10]. These studies relied on the size and shape of lymph nodes, and the analyses were based on region-specific comparisons. It was reported that margin and appearance are valid criteria for assessing lymph node metastasis from rectal cancer [11]. However, to our knowledge, no reports define the validity of criteria other than size and shape, and no reports have described node-by-node comparisons in the detection of metastatic pelvic lymph nodes in patients with uterine cervical carcinoma.The purpose of this study was to assess the accuracy of MRI in detecting metastatic lymph nodes in cervical cancer patients using various imaging criteria. Materials and Methods Patients and Staging WorkupPatients included in this retrospective study were those with histopathologically confirmed FIGO stages IB-IVA invasive cervical cancer, which was determined by a conventional workup that included MRI. Patients were recruited between October 2001 and October 2004, ranged in age from 18 to 65 years (mean age, 48 years), had no contraindications to the surgical procedure, had no evidence of distant metastases, and had an Eastern Cooperative Oncology Group performance status of 0-1. Patients with small cell carcinoma (n = 2) and patients who were not to undergo laparoscopic lymph node dissection (n = 63) were excluded.After histologic confirmation of invasive cervical carcinoma, the FIGO stage was determined using bimanual pelvic examination, excretory urograp...

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“…1 Fourteen patients had metastatic cervical cancer present in pelvic lymph nodes. These patients all received external radiation therapy.…”

Section: Fig 3 Marked Lymphoplasmacytic Infiltration Of Squamous Cementioning

confidence: 99%

The significance of vascular invasion and lymphocytic infiltration in invasive cervical cancer

Nagell

Donaldson

Wood

et al. 1978

Cancer

151

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Surgical specimens from 100 patients with stage I B cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy were reviewed with respect to vascular invasion and lymphoplasmacytic infiltration. Lymph nodes from these patients were classified morphologically according to the criteria proposed by Cottier. Vascular invasion was associated with a significant increase in nodal metastases and tumor recurrence particularly to extrapelvic sites. A marked lymphoplasmacytic infiltrate around tumor cells was associated with decreased nodal metastases and tumor recurrence. There was no significant relationship between the degree of lymphoplasmacytic infiltration of the primary tumor and regional lymph node morphology.

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Exploratory celiotomy for surgical staging of cervical cancer

Cited by 123 publications

References 6 publications

Experiences of pretreatment laparoscopic surgical staging in patients with locally advanced cervical cancer: results of a prospective study

Experiences of pretreatment laparoscopic surgical staging in patients with locally advanced cervical cancer: results of a prospective study

MRI for Pretreatment Lymph Node Staging in Uterine Cervical Cancer

The significance of vascular invasion and lymphocytic infiltration in invasive cervical cancer

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