Laparoscopic paraaortic surgical staging in locally advanced cervical cancer: a single-center experience

Vázquez-Vicente, Daniel; Bas, Bárbara Fernández del; Villayzán, José García; Fiore, Hugo Ariel Di; Tirado, J. Luna; Echarren, V. Casado; Garcı́a-Foncillas, Jesús; Arranz, Javier Plaza; Chiva, Luis

doi:10.1007/s12094-018-1878-4

Cited by 9 publications

(10 citation statements)

References 14 publications

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“…These articles were not part of the initial search result, because the title nor abstract included the 'lymphadenectomy' search term or synonyms. The final analysis included 16 studies [14,15,18,19,[25][26][27][28][29][30][31][32][33][34][35][36] reporting on 18 cohorts which were suitable for quantitative meta-analysis with pooling of upstaging outcomes.…”

Section: Identification Of Studiesmentioning

confidence: 99%

“…Characteristics of the 18 cohorts within 16 studies included in the quantitative synthesis are outlined in Table 2. Six studies [15,25,27,29,30,35] (38%) were prospective and 10 studies [14,18,19,26,28,[31][32][33][34]36] (63%) were retrospective by design. All studies used laparoscopic procedures.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Surgical approaches were extraperitoneal or retroperitoneal in 4 studies [26,[29][30][31], transperitoneal in 2 studies [35,36] and not reported in 1 study [25]. In 9 studies [14,15,18,19,28,[31][32][33][34], both surgical approaches were used. In 9 studies [14,15,19,29,30,[33][34][35][36], the upper level of dissection was the left renal vein, which is considered the golden standard.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Upstaging by para-aortic lymph node dissection in patients with locally advanced cervical cancer: A systematic review and meta-analysis

Thelissen

Jürgenliemk-Schulz

Leij

et al. 2022

Gynecologic Oncology

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Para-aortic lymph node (PALN) status in locally advanced cervical cancer has therapeutic and prognostic implications.• Reported proportions in literature of upstaging by PALN dissection after negative PALN imaging were meta-analyzed.• After negative PET or PET-CT, PALN dissection yielded pathologic PALNs in 12% of all patients.• After negative MRI or CT, PALN dissection yielded pathologic PALNs in 11% of all patients.• After PET-CT showed pelvic nodal (but no PALN) involvement, PALN dissection yielded pathologic PALNs in 21% of patients.

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Section: Identification Of Studiesmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Upstaging by para-aortic lymph node dissection in patients with locally advanced cervical cancer: A systematic review and meta-analysis

Thelissen

Jürgenliemk-Schulz

Leij

et al. 2022

Gynecologic Oncology

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“…Para-aortic lymph node (PALN) metastasis plays an important role in the metastasis of cervical cancer. It was reported that 13.5–20.2% of patients with locally advanced cervical cancer (LACC) had positive PALNs ( 2 – 5 ). For patients with FIGO stage IB, IIB and III disease, the incidences of PALN metastasis are 5%, 16% and 25% ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Prophylactic Extended-Field Irradiation in Patients With Cervical Cancer: A Literature Review

et al. 2020

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Currently, the standard radiation field for locally advanced cervical cancer patients without evidence of para-aortic lymph node (PALN) metastasis is the pelvis. Due to the low accuracy of imaging in the diagnosis of PALN metastasis and the high incidence of PALN failure after pelvic radiotherapy, prophylactic pelvic and para-aortic irradiation, also called extended-field irradiation (EFI), is performed for patients with cervical cancer. In the era of concurrent chemoradiotherapy, randomized controlled trials are limited, and whether patients with cervical cancer can benefit from prophylactic EFI is still controversial. With conformal or intensity-modulated radiation therapy, patients tolerate prophylactic EFI very well. The severe toxicities of prophylactic EFI are not significantly higher than those of pelvic radiotherapy. We recommend delivering prophylactic EFI to cervical cancer patients with common iliac lymph nodes metastasis. Clinical trials are needed to investigate whether patients with ≥3 positive pelvic lymph nodes and FIGO stage IIIB disease can benefit from prophylactic EFI. According to the distribution of PALNs, it is reasonable to use the renal vein as the upper border of the radiation therapy field for patients treated with prophylactic EFI. The clinical target volume expansion of the node from the vessel should be smaller in the right para-caval region than in the left lateral para-aortic region. The right para-caval region above L2 or L3 may be omitted from the PALN target volume to reduce the dose to the duodenum. More clinical trials on prophylactic EFI in cervical cancer are needed.

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“…To obtain a pathological diagnosis of para-aortic LNs, surgical biopsy with laparoscopy guidance under general anesthesia is sometimes performed [8,9]. However, imageguided percutaneous biopsy is preferred because it is less invasive, has lower complication rates, and has lower costs [2].…”

Section: Introductionmentioning

confidence: 99%

Computed Tomography Fluoroscopy-guided Core Needle Biopsy of Abdominal Para-aortic Lesions: A Retrospective Evaluation of the Diagnostic Yield and Safety

Tomita

Iguchi

Hiraki

et al. 2020

Interventional Radiology

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To retrospectively evaluate the diagnostic yield and safety of computed tomography (CT) fluoroscopy-guided biopsy of abdominal para-aortic lesions.Material and Methods: CT fluoroscopy-guided biopsy was performed for 30 lesions (median long diameter 2.4 cm; range, 1.3-12.4 cm) in 30 patients (11 women and 19 men; median age 64.5 years; age range 37-90 years) using 18-and/or 20-gauge needles. The median length of the biopsy needle tracts was 9.3 cm (range, 5.5-13.0 cm). The median number of biopsy fires was 3 (range, 2-6). The median duration of the procedures was 33 min (range, 14-80 min). The diagnostic yield and adverse events (AEs) were retrospectively evaluated. The AEs were categorized using the Society of Interventional Radiology classification system.Technical success was determined by the acquisition of a sufficient number of specimens for pathological diagnosis. Diagnostic yield was defined as the match between the pathological and final diagnoses.Results: In all 30 procedures, CT fluoroscopy-guided biopsies of the abdominal para-aortic lesions were technically successful. Twenty-six lesions were malignant (9 malignant lymphomas and 17 lymph node [LN] metastases) and four were benign (one schwannoma, one granular cell tumor, and two normal LNs). One case was insufficiently diagnosed as a B-cell lymphoma; thus, the diagnostic yield of the biopsy was 96.7%. AEs occurred in seven procedures (23.3%), including six cases of class A hemorrhage and one case of class B vasovagal reaction.Conclusions: CT fluoroscopy-guided biopsy of abdominal para-aortic lesions is a safe procedure and provides a high diagnostic yield.

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Laparoscopic paraaortic surgical staging in locally advanced cervical cancer: a single-center experience

Abstract: Pretherapeutic laparoscopic paraaortic lymphadenectomy for locally advanced cervical carcinoma allows the adaption of radiotherapy fields to avoid false-positive and false-negative imaging results.

Cited by 9 publications

References 14 publications

Upstaging by para-aortic lymph node dissection in patients with locally advanced cervical cancer: A systematic review and meta-analysis

Upstaging by para-aortic lymph node dissection in patients with locally advanced cervical cancer: A systematic review and meta-analysis

Prophylactic Extended-Field Irradiation in Patients With Cervical Cancer: A Literature Review

Computed Tomography Fluoroscopy-guided Core Needle Biopsy of Abdominal Para-aortic Lesions: A Retrospective Evaluation of the Diagnostic Yield and Safety

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