Introduction/Background The purpose of this study is to assess the safety and feasibility of transperitoneal laparoscopic pelvic lymphadenectomy in patients with locally advanced cervical cancer (LACC), who are going to undergo staging para-aortic lymphadenectomy and to analyze the prognostic value and the impact on survival of this procedure.
Methodology Data from 67 patients with LACC who underwent transperitonel laparoscopic para-aortic plus pelvic lymphadenectomy and received chemoradiation therapy were analyzed.
Results Metastatic lymph nodes (LN) were identified in 32 patients (47.7%), 20 (29.8%) had metastatic LN in the pelvic area and 12 (17,9%) had metastatic LN in the pelvic and para-aortic area. None of them had metastatic LN localized only in the para-aortic area.
After a median follow-up of 54.6 months (5–122.2 months), the 5-year overall survival (OS) for the whole group was 67.3%. Patients with para-aortic nodal metastasis had increased risk of mortality than those with negative nodes (p=0.005), but there were no significant differences in OS between patients with negative nodes and those with only pelvic nodes affected (p=0.380).
The 5-year local control rate for the whole group was 91.1%. The 5-year disease-free survival (DFS) for the whole group was 60.5%. For patients with no metastatic LN the DFS was 86.4%, while for patients with pelvic metastatic LN was 34.2% and 24.2% for patients with pelvic and para-aortic metastatic LN (p<0.001).
This program allowed a modification of the initial therapeutical plan in the para-aortic area in 13.4% of patients and in the pelvic area in 28.3% of patients. Overall intraoperative morbidity rate was 5.9%.
Conclusion Transperitoneal pelvic and para-aortic lymphadenectomy provides precise information about nodal state and allows personalized treatment planning in patients with LACC. No differences in OS were observed between patients with negative LN and patients with only positive pelvic LN
Disclosure Nothing to disclose.
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