RT Journal Article
SR Electronic
T1 Laparoscopic para- aortic lymphadenectomy and positron emission tomography scan as staging procedures in patients with cervical carcinoma stage IB2–IIIB
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP 723
OP 729
DO 10.1136/ijgc-00009577-200807000-00017
VO 18
IS 4
A1 Mortier, D. G.
A1 Stroobants, S.
A1 Amant, F.
A1 Neven, P.
A1 Van Limbergen, E.
A1 Vergote, I.
YR 2008
UL http://ijgc.bmj.com/content/18/4/723.abstract
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.