Laparoscopic laterally extended endopelvic resection (LEER) for cervical carcinoma recurring at the pelvic sidewall after concurrent chemoradiotherapy: Our experience in three cases

Kanao, Hiroyuki; Aoki, Yoichi; Hisa, Tsuyoshi; Takeshima, Nobuhiro

doi:10.1016/j.ygyno.2018.02.002

Cited by 10 publications

(6 citation statements)

References 3 publications

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“…Despite these limitations, LEER reportedly produces a five-year survival rate of about 50%, and the number of studies on the feasibility of LEER for selected patients with PSRCC has gradually been increasing since 2015 (6,(9)(10)(11)(12)(13)(14). However, the criteria for identification of patients for whom LEER may be beneficial remain ambiguous, and there is no evidence as to whether LEER may be more effective than palliative chemo or targeted therapy alone.…”

Section: Introductionmentioning

confidence: 99%

“…However, LEER is a highly skilled surgery that can only be done by a proficient surgeon. It requires definite anatomical knowledge of pelvic sidewall structure due to the risk of massive bleeding during resection of tumors invading the major pelvic vessels, and adhesion and fibrosis in a previously debulked or irradiated pelvis can increase surgical morbidity and mortality ( 9 , 10 ).…”

Section: Introductionmentioning

confidence: 99%

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Laterally Extended Endopelvic Resection Versus Chemo or Targeted Therapy Alone for Pelvic Sidewall Recurrence of Cervical Cancer

et al. 2021

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BackgroundLaterally extended endopelvic resection (LEER) has been introduced for treatment of pelvic sidewall recurrence of cervical cancer (PSRCC), which occurs in only 8% of patients with relapsed cervical cancer. LEER can only be performed by a proficient surgeon due to the high risk of surgical morbidity and mortality, but there is no evidence as to whether LEER is may be more effective than chemo or targeted therapy alone for PSRCC. Thus, we aimed to compare the efficacy and safety between LEER and chemo or targeted therapy alone for treatment of PSRCC.MethodsWe prospectively recruited patients with PSRCC who underwent LEER between December 2016 and December 2019. Moreover, we retrospectively collected data on patients with PSRCC who received chemo or targeted therapy alone between January 2000 and December 2019. We compared treatment-free interval (TFI), progression-free survival (PFS), treatment-free survival (TFS), overall survival (OS), tumor response, neurologic disturbance of the low extremities, and pelvic pain severity in the different patient groups.ResultsAmong 1295 patients with cervical cancer, we included 28 (2.2%) and 31 (2.4%) in the prospective and retrospective cohorts, respectively. When we subdivided all patients into two groups based on the median value of prior TFI (PTFI, 9.2 months), LEER improved TFI, PFS, TRS and OS compared to chemo or targeted therapy alone (median, 2.8 vs. 0.9; 7.4 vs. 4.1; 30.1 vs. 16.9 months; P ≤ 0.05) in patients with PTFI < 9.2 months despite no difference in survival in those with PTFI ≥ 9.2 months, suggesting that LEER may lead to better TFI, PFS, TRS and OS in patients with PTFI < 9.2 months (adjusted hazard ratios, 0.28, 0.27, 0.44 and 0.37; 95% confidence intervals, 0.12-0.68, 0.11-0.66, 0.18-0.83 and 0.15-0.88). Furthermore, LEER markedly reduced the number of morphine milligram equivalents necessary to reduce pelvic pain when compared with chemo or targeted therapy alone.ConclusionCompared to chemo or targeted therapy alone, LEER improved survival in patients with PSRCC and PTFI < 9.2 months, and it was effective at controlling the pelvic pain associated with PSRCC.Trial RegistrationClinicalTrials.gov, identifier NCT02986568.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Laterally Extended Endopelvic Resection Versus Chemo or Targeted Therapy Alone for Pelvic Sidewall Recurrence of Cervical Cancer

et al. 2021

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“…The patient in the present report had the first recurrence at the incisional site, which was successfully treated with wide local excision without chemotherapy. A study found that the 5-year survival rate was 62% in patients who underwent locally extended endopelvic resection with a negative margin for recurrent cervical carcinoma [6]. Cut margin negativity and absence of other organ metastasis probably contributed to the patient's subsequent recurrence-free survival of 6 years.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Squamous Cell Carcinoma of the Cervix With Incisional Site Recurrence

Sultana¹

2022

Cureus

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Incisional site metastasis in abdominal malignancy following laparotomy is uncommon and extremely rare in cervical cancer. The prognosis is poor in these patients, as they also present with distant organ metastasis. We report a case of squamous cell carcinoma of the cervix in a 40-year-old woman primarily treated with radical hysterectomy and concurrent chemoradiotherapy. Later on, she presented with incisional scar site recurrence and underwent surgical excision of the metastatic site several times along with chemotherapy. She has been in stable condition for nearly 10 years since her first recurrence. We highlighted the management strategies of this patient that contributed to her longevity.

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“…Participants with prior experience in performing tumor resection surgeries performed the same operation on a different cadaver, under the supervision of the expert. Incisions were made at the internal iliac vessels and rectum to expose the L5/S1–3 nerves 13 . The coccygeus muscle and sacrospinous ligament were identified.…”

Section: Methodsmentioning

confidence: 99%

A mixed‐method evaluation of cadaver surgery training for gynecologic oncology

Tamate

Matsuura

Kanao

et al. 2022

J of Obstet and Gynaecol

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Aim: Traditional surgical training techniques with using patients, and new advances with live animals, artificial models, and simulation methods have several shortcomings. There are a few reports on the usefulness of cadaver surgery training (CST) in gynecology. Herein, we used a mixed-method evaluation to qualitatively and quantitatively explore the educational efficacy of CST by conducting CST programs at the

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Laparoscopic laterally extended endopelvic resection (LEER) for cervical carcinoma recurring at the pelvic sidewall after concurrent chemoradiotherapy: Our experience in three cases

Cited by 10 publications

References 3 publications

Laterally Extended Endopelvic Resection Versus Chemo or Targeted Therapy Alone for Pelvic Sidewall Recurrence of Cervical Cancer

Laterally Extended Endopelvic Resection Versus Chemo or Targeted Therapy Alone for Pelvic Sidewall Recurrence of Cervical Cancer

A Rare Case of Squamous Cell Carcinoma of the Cervix With Incisional Site Recurrence

A mixed‐method evaluation of cadaver surgery training for gynecologic oncology

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