Laparoscopic surgical staging of locally advanced cervix cancer (IB2 to IVA):initial experience

Zanvettor, Paulo Henrique; Filho, Deraldo Fernando Falcão; Neves, Adson Roberto Santos; Amorim, Maria Jose N.; Medeiros, Sonia M.; Laranjeiras, Luiz Carlos F.; Morais, Jackson A.; Araujo, Iguaracyra; Barbosa, Helenemarie S.

doi:10.1016/j.ygyno.2010.12.335

Cited by 10 publications

(10 citation statements)

References 34 publications

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“…Pelvic lymph node metastases were detected in more than half of the patients in the surgical arm (51%), similar to the range observed by del Pino et al [9] . Most importantly, the 24% upstaging due to para-aortic lymph node involvement in our study is in accordance with other studies [2,[8][9][10][11][12][13][14][15][16][17][18][19][20] . Interestingly, the median number of harvested para-aortic lymph nodes varies considerably in the literature, probably due to the different intentions of staging procedures.…”

Section: Discussionsupporting

confidence: 93%

“…The incidence of lymph node metastases varies considerably within prospective and retrospective studies, from 22 to 53% for pelvic nodes and from 0 to 38% for para-aortic nodes [2,[8][9][10][11][12][13][14][15][16][17][18][19][20] . After adjustment for tumor stage, the incidence of para-aortic lymph node metastases in stages IB2, IIB, IIIB, and IVA is 2.35-20, 0-27, 9-60, and 0-100%, respectively [21][22][23][24][25][26][27][28][29][30][31][32] .…”

Section: Introductionmentioning

confidence: 99%

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Incidence of Histologically Proven Pelvic and Para-Aortic Lymph Node Metastases and Rate of Upstaging in Patients with Locally Advanced Cervical Cancer: Results of a Prospective Randomized Trial

Tsunoda

Marnitz²,

Nunes

et al. 2017

Oncology

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Background: Surgical staging is associated with a significant rate of upstaging compared to clinical/radiological staging in patients with locally advanced cervical cancer. Objective: To analyze the stage-specific percentage of pelvic and para-aortic lymph node metastases and the upstaging ratio in a prospective randomized trial (Uterus-11). Methods: FIGO stage IIB-IVA cervical cancer patients were randomized to surgical staging (arm A) or to clinical staging and primary chemoradiation (arm B). Arm B patients underwent CT-guided biopsy of suspicious para-aortic lymph nodes. Confirmed para-aortic metastasis patients received extended-field radiation therapy. Results: A total of 234 patients were enrolled, including 120 (arm A) and 114 (arm B) treated per protocol. The groups were well balanced. Pelvic and para-aortic lymph node metastases were identified after surgical staging in 51 and 24% of patients, respectively (p < 0.001). Pelvic and para-aortic lymph node metastases were confirmed in 45 and 20% of IIB patients and in 71 and 37% of IIIB patients, respectively. Upstaging occurred in 39/120 (33%) in arm A and in 9/114 (8%) in arm B (p < 0.001). Conclusion: The histological results in both groups led to a considerable rate of upstaging. Oncological data from the Uterus-11 study may reveal whether modified therapy translates into a survival benefit.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Incidence of Histologically Proven Pelvic and Para-Aortic Lymph Node Metastases and Rate of Upstaging in Patients with Locally Advanced Cervical Cancer: Results of a Prospective Randomized Trial

Tsunoda

Marnitz²,

Nunes

et al. 2017

Oncology

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“…During laparoscopy staging, they are mainly focused on pelvic and/or aortic lymphadenectomy [12,13,29,30,31] in order to extend radiation fields to the aortic area only in the cases when an aortic nodal spread is proven by pathological examination. In addition, it is demonstrated that surgical staging offers the possibility to identify a percentage of occult node-positive cases (12-22%), which are missed by preoperative imaging staging [30].…”

Section: Discussionmentioning

confidence: 99%

“…In 1999, we reported that laparoscopy in patients with locally advanced cervical cancer (LACC) is a feasible and well-tolerated procedure to detect abdominal disease [6]. Later, several authors confirmed these favorable data [1,2,11,12,13]. …”

Section: Introductionmentioning

confidence: 99%

An Update of Laparoscopy in Cervical Cancer Staging: Is It a Useful Procedure?

et al. 2013

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Objective: It was the aim of this study to report on the role of laparoscopic staging in a large series of locally advanced cervical cancer (LACC) patients and its impact on prognosis. Methods: Consecutive patients with LACC were considered for surgical staging: gynecological examination, cystoscopy and laparoscopy with peritoneal biopsies and peritoneal fluid cytology. Results: Between February 2000 and September 2010, a total of 167 women were evaluated. In 5 patients, laparoscopy could not be performed. One hundred and sixty-two patients had correct laparoscopic staging: 49 International Federation of Gynecology and Obstetrics (FIGO) stage IB-IIA (>4 cm), 67 IIB, 39 III, and 7 IVA. Abdominal spread was found in 33 cases (20%). There was a minor laparoscopy complication rate of 1%. We found a significant difference in the distribution of peritoneal spread for tumor grade and FIGO stage (p = 0.01 and p < 0.0001, respectively), whereas no statistically significant difference for the histological type was found [p = not significant (NS)]. The median follow-up was 80 months (range 4-144). The median overall survival was 65 months. The patients without abdominal spread did not benefit from a significantly longer survival (median overall survival of 59 vs. 70 months; p = NS). Conclusions: Laparoscopic staging in cervical cancer is a safe and feasible technique but it does not modify the prognosis of LACC patients.

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“…Так, при выявлении метастазов в лимфатических узлах при срочном гисто-логическом исследовании от радикальной гистерэкто-мии отказывались, оставляя приоритет за неоадъю-вантной терапией. В среднем изменение плана лечения происходило у 15-20 % больных [27].…”

Section: обзорные статьиunclassified

Approaches to surgical staging of cancer of the uterine cervix

Бежанова¹,

Berlev²

2017

Tumors of female reproductive system

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Laparoscopic surgical staging of locally advanced cervix cancer (IB2 to IVA):initial experience

Cited by 10 publications

References 34 publications

Incidence of Histologically Proven Pelvic and Para-Aortic Lymph Node Metastases and Rate of Upstaging in Patients with Locally Advanced Cervical Cancer: Results of a Prospective Randomized Trial

Incidence of Histologically Proven Pelvic and Para-Aortic Lymph Node Metastases and Rate of Upstaging in Patients with Locally Advanced Cervical Cancer: Results of a Prospective Randomized Trial

An Update of Laparoscopy in Cervical Cancer Staging: Is It a Useful Procedure?

Approaches to surgical staging of cancer of the uterine cervix

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