Laparoscopic para- aortic lymphadenectomy and positron emission tomography scan as staging procedures in patients with cervical carcinoma stage IB2–IIIB. Issue 4 (1st July 2008)

• Record Type: Journal Article
• Authors: Mortier, D. G.; Stroobants, S.; Amant, F.; Neven, P.; Van Limbergen, E.; Vergote, I.
• Is Part Of: International journal of gynecological cancer. Volume 18:Issue 4(2008)
• Page Start: 723
• Page End: 729
• Publication Date: 2008-07-01
• Subjects: cervical neoplasms -- endoscopy -- laparoscopy -- PET -- staging; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-00009577-200807000-00017
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : The objective of this study was to determine the role of laparoscopic lower para-aortic lymphadenectomy and positron emission tomography (PET) scan in the staging of cervical carcinoma. Ninety consecutive patients with FIGO stage IB2–IIIB were scheduled for laparoscopic para-aortic lymphadenectomy. Exclusion criteria: obvious metastatic para-aortic nodes on computed tomography (CT)/PET or PET–CT. The procedure was stopped when a node was positive on frozen section. In ten patients, no para-aortic lymphadenectomy was performed as scheduled. Forty-seven patients were operated retroperitoneally, 22 transperitoneally, and 21 cases were converted from retroperitoneally to transperitoneally. Median number of removed nodes was 6 (1–24). In 10 of 80 patients, para-aortic metastases were diagnosed. Despite a nonsuspect PET result, 5 of 44 patients had positive para-aortic nodes. Two-year survival was 76% and 16% without and with para-aortic metastases, respectively ( P = 0.0001). Laparoscopic para-aortic lymphadenectomy showed metastases in 13% of the patients. In the subgroup with negative PET scan, 11% had metastases. The procedure had a low morbidity and identified a group with an extremely poor prognosis.