Extraperitoneal endosurgical aortic and common iliac dissection in the staging of bulky or advanced cervical carcinomas

Querleu, Denis; Dargent, D; Ansquer, Yan; Leblanc, Éric; Narducci, Fabrice

doi:10.1002/(sici)1097-0142(20000415)88:8<1883::aid-cncr18>3.0.co;2-3

Cited by 126 publications

(52 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Laparoscopic para-aortic lymphadenectomy was performed by a single surgeon (S.C.D.) using a retroperitoneal approach to access the left and right para-aortic node basins through the left flank area [29,30]. This method was chosen for the consistency with which it allows removal of lymph nodes up to the level of the renal veins, even in obese patients with a body mass index (weight in kg divided by height in m 2 ) greater than 40.…”

Section: Methodsmentioning

confidence: 99%

Prospective assessment of lymphatic dissemination in endometrial cancer: A paradigm shift in surgical staging

Mariani

Dowdy

Cliby

et al. 2008

Gynecologic Oncology

764

528

View full text Add to dashboard Cite

Objective-To prospectively assess pelvic and para-aortic lymph node metastases in endometrial cancer with lymphatic dissemination, emphasizing the examination of para-aortic metastases relative to the inferior mesenteric artery (IMA).Methods-Over 36 months, 422 consecutive patients were managed by predefined surgical guidelines differentiating low-risk patients from patients at risk for dissemination requiring systematic lymphadenectomy. Low risk was defined as grade 1 or 2 endometrioid type with myometrial invasion (MI) ≤50% and primary tumor diameter (PTD) ≤2 cm. Pelvic and para-aortic lymph nodes were submitted separately, with nodes identified from all 8 pelvic and 4 para-aortic node-bearing basins. Surgical quality assessments examined median node counts (primary surrogate for quality) and nodes harvested above and below the IMA and excised gonadal veins (secondary surrogates).Results-Lymphadenectomy was not required in 27% of patients (all low risk) and in 33% (n=112) of endometrioid cases. However, 22 patients (20%) of this latter cohort had lymphadenectomy and all lymph nodes were negative. Sixty-three (22%) of 281 patients undergoing lymphadenectomy had lymph node metastases: both pelvic and para-aortic in 51%, only pelvic in 33%, and isolated to the para-aortic area in 16%. Therefore, 67% of patients with lymphatic dissemination had para-aortic lymph node metastases. Furthermore, 77% of patients with para-aortic node involvement had metastases above the IMA, whereas nodes in the ipsilateral para-aortic area below the IMA and ipsilateral common iliac basin were declared negative in 60% and 71%, respectively. Gonadal veins were excised in 25 patients with para-aortic node metastases; 7 patients (28%) had documented metastatic involvement of gonadal veins or surrounding soft tissue.Conclusions-The high rate of lymphatic metastasis above the IMA indicates the need for systematic pelvic and para-aortic lymphadenectomy (vs sampling) up to the renal vessels. The latter should include consideration of excision of the gonadal veins. Conversely, lymphadenectomy does not benefit patients with grade 1 and 2 endometrioid lesions with MI ≤50% and PTD ≤2 cm.

show abstract

Section: Methodsmentioning

confidence: 99%

Prospective assessment of lymphatic dissemination in endometrial cancer: A paradigm shift in surgical staging

Mariani

Dowdy

Cliby

et al. 2008

Gynecologic Oncology

764

528

View full text Add to dashboard Cite

show abstract

“…The patient is placed in dorsal decubitus position, the same position used for conventional extra peritoneal dissection, as previously described by Querleu et al [22]. The procedure starts with a standard transperitoneal laparoscopy.…”

Section: Methodsmentioning

confidence: 99%

Laparoscopic extraperitoneal aortic dissection: does single-port surgery offer the same possibilities as conventional laparoscopy?

et al. 2012

View full text Add to dashboard Cite

The study results demonstrate the feasibility of single-port-access laparoscopy for extraperitoneal aortic lymphadenectomy. The lymph node count was similar to that described in the published experience of conventional laparoscopic extraperitoneal dissection. This preliminary report shows that SPS is usable for extraperitoneal aortic dissection and that it is possible to perform this procedure using only one skin incision compared with the three or four incisions required for conventional laparoscopy.

show abstract

“…[13][14][15][16][17] Laparoscopic LN staging was expected to maximize effect of radiotherapy by modifying radiotherapy field and by resection of bulky metastatic LN. 18 This study was conducted to investigate the feasibility, morbidity and treatment modification by pretreatment laparoscopic surgical staging in patients with locally advanced cervical cancer.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2008

View full text Add to dashboard Cite

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.

show abstract

Extraperitoneal endosurgical aortic and common iliac dissection in the staging of bulky or advanced cervical carcinomas

Cited by 126 publications

References 26 publications

Prospective assessment of lymphatic dissemination in endometrial cancer: A paradigm shift in surgical staging

Prospective assessment of lymphatic dissemination in endometrial cancer: A paradigm shift in surgical staging

Laparoscopic extraperitoneal aortic dissection: does single-port surgery offer the same possibilities as conventional laparoscopy?

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

Contact Info

Product

Resources

About