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1169 Robotic-assisted lymphadenectomy in pregnancy as cervical cancer staging – a case report
  1. B Bittnerová,
  2. R Pilka,
  3. V Staňková,
  4. M Janošík,
  5. P Dzvinčuk and
  6. R Marek
  1. University Hospital Olomouc, Department of Obstetrics and Gynaecology, Olomouc, Czech Republic


Introduction/Background*Cervical cancer represents one of the most commonly diagnosed tumours in pregnancy. Robotic-assisted surgery is considered the standard method for surgical staging of cervical cancer. There is a very limited data in the available literature on the use of this method to perform lymphadenectomy in patients with cervical cancer during pregnancy. In the case report we describe the procedure of robotic pelvic lymphadenectomy in a patient with cervical cancer T1b in pregnancy.

Methodology A 43 years old nulliparous woman pregnant for the third time was referred to our department with a confirmed cervical adenocarcinoma in the 15th week of pregnancy. According to the preoperative imaging examination (pelvic MRI scan, expert sonography), she suffered from stage T1b cervical cancer. The patient preferred the continuation of the pregnancy. Informed about the associated risks, she signed an informed refusal rejecting proposed radical surgical treatment. Based on the recommendation of the multidisciplinary team of gynaecological oncology, a surgical staging procedure was indicated before possible neoadjuvant systemic therapy. The robotic-assisted laparoscopic lymphadenectomy was performed on 21.5.2020 as a surgical modality of a minimally invasive approach. The procedure was performed without any complications, blood loss was up to 20 ml. Histopathological examination excluded the cancer dissemination into the lymph nodes. Subsequently, systemic treatment (cisDDP + Paclitaxel) was administered for 9 cycles to ensure adequate foetal maturity. Planned caesarean sections combined with a radical surgical treatment – radical hysterectomy and bilateral adnexectomy – were performed in gestational age 30 weeks and 5 days.

Result(s)*According to definitive histology and after the neoadjuvant treatment the stage of the disease was classified as FIGO IA1 ypT1a1 ypN0 ypMX Mandard TRG3. A close follow-up is ongoing in the patient.

Conclusion*In pregnant patients with cervical cancer, robot-assisted laparoscopic lymphadenectomy is a very gentle and effective method of staging.

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