Introduction/Background Cervical cancer is one of the most commonly occurring female cancers with increasing incidence worldwide. The mainstay of treatment for locally advanced cervical cancer is primary chemoradiotherapy. Pre-operative imaging alongside laparoscopic extraperitoneal para-aortic node dissection (LEPAND) has been used in order to best target this treatment. This study looked at all the women in the Belfast Trust over the last 9 years who had this investigation done as part of their pre-treatment workup and their outcomes.
Methodology Retrospective data was collected for all those who had LEPAND for locally advanced cervical cancer from January 2010 to December 2018. These women all had pre-operative imaging that suggested positive pelvic lymph nodes but negative para-aortic nodes therefore deeming them suitable for the surgery.
Results Sixty women were identified in this group with an age range from 23–69 and median age of 39. 93.3% had stage 2b cervical cancer, the remainder were 1b2 or 3b. 17% had adenocarcinoma of the cervix and 83% had squamous cell carcinoma.
70% of the women had primary LEPAND surgery before chemoradiotherapy with the remainder having their primary treatment before surgery.
5% (3/60) had positive para-aortic nodes on histopathology although 100% appeared node negative on MRI or PET imaging. None of those with positive nodes had recurrences but 66% died within 2 years.
15% of the study population died with 90% of these in the two years after diagnosis. 67% of these women had primary LEPAND followed by chemoradiotherapy with the others proceeding straight to primary treatment. The median survival for this group is 5 years.
Conclusion 5% of the group had positive para-aortic lymph nodes on histopathological examination. This was despite imaging stating that they were node negative.LEPAND surgery prevented undertreatment in these women by re-targeting their radiotherapy.
Disclosure Nothing to disclose.
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