Title
Laparoscopic para-aortic lymphadenectomy and positron emission tomography scan as staging procedures in patients with cervical carcinoma stage IB2-IIIB Laparoscopic para-aortic lymphadenectomy and positron emission tomography scan as staging procedures in patients with cervical carcinoma stage IB2-IIIB
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
Cambridge, Mass. ,
Subject
Human medicine
Source (journal)
International journal of gynecological cancer. - Cambridge, Mass.
Volume/pages
18(2008) :4 , p. 723-729
ISSN
1048-891X
ISI
000257662900017
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Abstract
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 IB2IIIB were scheduled for laparoscopic para-aortic lymphadenectomy. Exclusion criteria: obvious metastatic para-aortic nodes on computed tomography (CT)/PET or PETCT. 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 (124). 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.
E-info
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