J Gynecol Oncol.  2008 Jun;19(2):123-128. 10.3802/jgo.2008.19.2.123.

Experiences of pretreatment laparoscopic surgical staging in patients with locally advanced cervical cancer: results of a prospective study

• Lim MC
• Bae J
• Park JY
• Lim S
• Kang S
• Seo SS
• Kim JY
• Rho JW
• Park SY

• KMID: 2129912
• DOI: http://doi.org/10.3802/jgo.2008.19.2.123

Abstract

OBJECTIVE
To prospectively evaluate the feasibility, safety, and survival of laparoscopic surgical staging in patients with locally advanced cervical cancer.
METHODS
From Oct 2001 to Jul 2006, a total of 83 consecutive patients were eligible for inclusion and underwent laparoscopic surgical staging.
RESULTS
Three patients with intraoperative great vessel injury and 1 patient in whom the colpotomizer was unable to be inserted were excluded. Laparoscopic surgical staging was feasible in 95.2% (79/83). Immediate postoperative complications were noted in 12 (15.2%) patients. Prolonged complications directly related to operative procedures numbered 2 (2.5%), and were trocar site metastases. The mean time from surgery to the start of radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) was 11 (5-35) days. All patients tolerated the treatment well and completed scheduled RT or CCRT without disruption of treatment and additional admission. The rate of modification of the radiation field after surgical staging was 8.9% (7/79). Five-year progression-free survival and overall survival (OS) rates were 79% and 89%, respectively. The OS of patients with microscopic lymph node metastases, which were fully resected, were comparable to those of patients without lymph node metastasis. However, the OS of patients with macroscopic lymph node metastases that were fully resected were poorer compared with those of patients without lymph node metastasis.
CONCLUSION
Pretreatment laparoscopic surgical staging is a feasible and safe treatment modality. However the survival benefit of debulking lymph nodes or full lymph node dissection is not clear.

Keyword

Cervical cancer; Laparoscopic surgical staging; Lymph nodes

MeSH Terms

Chemoradiotherapy
Disease-Free Survival
Glycosaminoglycans
Humans
Lymph Node Excision
Lymph Nodes
Neoplasm Metastasis
Postoperative Complications
Prospective Studies
Surgical Instruments
Surgical Procedures, Operative
Uterine Cervical Neoplasms
Glycosaminoglycans

Figure

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  Fig. 1 Progression free survival underwent laparoscopic surgical staging in patients with locally advanced cervical cancer.

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  Fig. 2 Overall survival underwent laparoscopic surgical staging in patients with locally advanced cervical cancer.

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  Fig. 3 Overall survival underwent laparoscopic surgical staging in patients with locally advanced cervical cancer by lymph node status.

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