Prospective evaluation of surgical staging of advanced cervical cancer via a laparoscopic extraperitoneal approach

Sonoda, Yukio; Leblanc, Éric; Querleu, Denis; Castelain, B.; Papageorgiou, Theodotis; Lambaudie, Éric; Narducci, Fabrice

doi:10.1016/j.ygyno.2003.07.008

Cited by 124 publications

(66 citation statements)

References 19 publications

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“…In our study, we had no treatment-related deaths and only 5% required surgery to correct a treatment-related complication. Our study confirms the results of other investigators that show that SS achieved through an extraperitoneal or laparoscopic approach is not associated with an increased risk of radiation injury [6,16,19,20,32]. Our study also confirmed the previously unreported importance of concurrent CT for the treatment of women with locally advanced cervical cancer.…”

Section: Journal Of Surgical Oncologysupporting

confidence: 91%

“…The presence of LN metastasis appears to be the most important predictor for risk of distant failure. The mean number of dissected LNs and the mean operative time in our study were comparable to other series evaluating pelvic and para-aortic lymphadenectomy [18][19][20]. All women with or without nodal metastasis were offered primary and/or concurrent CT in an effort to reduce the risk of distant failure.…”

Section: Discussionsupporting

confidence: 75%

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Impact of surgical staging in locally advanced cervical cancer and subsequent chemotherapy

Marana

Andrade

Reis

et al. 2009

Journal of Surgical Oncology

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Section: Journal Of Surgical Oncologysupporting

confidence: 91%

Section: Discussionsupporting

confidence: 75%

Impact of surgical staging in locally advanced cervical cancer and subsequent chemotherapy

Marana

Andrade

Reis

et al. 2009

Journal of Surgical Oncology

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“…Laparoscopy, with its characteristics of minimal invasiveness, is considered an effective diagnostic procedure to detect abdominal spread in gynecological cancers [1,2,3,4,5,6,7,8,9,10]. 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].…”

Section: Introductionmentioning

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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“…[15][16][17][18] On the other hand, the first randomized study of Lai et al 19 revealed a significant worse DFS rate of surgically staged patients than that of clinically staged patients. After Lai's study, there were a couple of reports which demonstrated survival benefits of LSS through therapeutic effect of removal of metastatic LNs and tailored RT.…”

Section: Discussionmentioning

confidence: 99%

Survival benefit of laparoscopic surgical staging-guided radiation therapy in locally advanced cervical cancer

et al. 2010

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Objective: This study was designed to evaluate the survival benefit of laparoscopic surgical staging (LSS)-guided tailored radiation therapy (RT) in locally advanced cervical cancer (LACC). Methods: We retrospectively reviewed 89 LACC patients' medical records who primarily received non-surgical treatment, of which pretreatment LSS was performed in 20 (LSS group) and primary chemoradiation therapy (CCRT) without LSS (CCRT group) was carried out in 69 from January 2000 to January 2006. We analyzed clinical characteristics, pretreatment imaging study results and survival outcomes including disease free survival (DFS) and overall survival (OS) to compare them between the two groups. Results: There were as many as eight cases (40%) of LSS related complications. The mean time interval between LSS and RT or CCRT was 26.6 days (±18.8 days). Six out of twenty (30%) in LSS group and 10 out of 69 (14.5%) in CCRT group received extended field RT when paraaortic lymph nodes (LNs) were positive based on the pathologic findings after LSS and the results of imaging studies, respectively. Three-year DFS and OS were both better in 33 imaging-negative CCRT group patients than those in 4 imaging-negative/pathology-positive (false negative) patients after LSS (3-year DFS, 50% vs. 87%, p=0.022; 3-year OS, 50% vs. 84%, p=0.033). The 5-year DFS rates were 52% and 55% in LSS group and in CCRT group, respectively (p=0.28). The 5-year OS rates were 68% in LSS group and 62% in CCRT group without significant difference between the two groups (p=0.79). Conclusion:We found that LSS-based RT tailoring did not show survival benefit in LACC despite inaccuracy of imaging-based RT tailoring. Further studies are required to find new method to overcome this inaccuracy and improve survival outcomes.

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Prospective evaluation of surgical staging of advanced cervical cancer via a laparoscopic extraperitoneal approach

Cited by 124 publications

References 19 publications

Impact of surgical staging in locally advanced cervical cancer and subsequent chemotherapy

Impact of surgical staging in locally advanced cervical cancer and subsequent chemotherapy

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

Survival benefit of laparoscopic surgical staging-guided radiation therapy in locally advanced cervical cancer

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