PT  - JOURNAL ARTICLE
AU  - Mortier, D. G.
AU  - Stroobants, S.
AU  - Amant, F.
AU  - Neven, P.
AU  - Van Limbergen, E.
AU  - Vergote, I.
TI  - Laparoscopic para- aortic lymphadenectomy and positron emission tomography scan as staging procedures in patients with cervical carcinoma stage IB2–IIIB
AID  - 10.1136/ijgc-00009577-200807000-00017
DP  - 2008 Jul 01
TA  - International Journal of Gynecologic Cancer
PG  - 723--729
VI  - 18
IP  - 4
4099  - http://ijgc.bmj.com/content/18/4/723.short
4100  - http://ijgc.bmj.com/content/18/4/723.full
SO  - Int J Gynecol Cancer2008 Jul 01; 18
AB  - 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.