caa a22 4500 445338245 CHVBK 20180317142803.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1245/s10434-010-1320-9 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1320-9 Pretherapeutic Extraperitoneal Laparoscopic Staging of Bulky or Locally Advanced Cervical Cancer [Elektronische Daten] [Antonio Gil-Moreno, Silvia Franco-Camps, Silvia Cabrera, Assumpció Pérez-Benavente, Xavier Martínez-Gómez, Angel Garcia, Jordi Xercavins] Background: To assess the safety, feasibility, and impact on survival of extraperitoneal para-aortic lymphadenectomy in the staging of patients with bulky or locally advanced cervical cancer. Materials and Methods: Between August 2001 and October 2009, 87 consecutive patients (median age 51years) with bulky or locally advanced cervical cancer underwent extraperitoneal laparoscopic infrarenal aortic and common iliac dissection as a pretherapeutic staging procedure. Data on pathologic findings, details of surgery, postoperative complications, and disease status at follow-up were collected. Results: The median operating time was 150min (range 60-255min). The mean (±standard deviation) para-aortic nodal yield was 15.5±8.1 (range 4-62). In none of the patients, conversion to the transperitoneal approach or laparotomy was necessary. Histological examination revealed metastasis in 13 patients (macroscopic disease 10, microscopic disease 3). After a median follow-up of 33.4months (range 13.3-65.9months), 73.6% of patients were free of disease and 1.1% were alive with disease, 19.5% died from cervical cancer, and 3.3% died from other causes. After a follow-up of 3years, no deaths or recurrences were documented, with an overall survival rate of 74.8% (95% CI 62.8%-83.4%) and disease-free survival of 86% (95% CI 74.7%-92.5%). There were no significant differences in overall survival and disease-free survival between patients with positive and negative para-aortic lymph nodes. Conclusion: The extraperitoneal laparoscopic para-aortic lymphadenectomy for pretherapeutic surgical staging in cervical cancer is a safe and feasible procedure that should be considered as a tool to identify lymph node positive patients who require extended-field radiation and/or chemotherapy. Society of Surgical Oncology, 2010 Gil-Moreno Antonio Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain aut Franco-Camps Silvia Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain aut Cabrera Silvia Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain aut Pérez-Benavente Assumpció Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain aut Martínez-Gómez Xavier Service of Epidemiology and Preventive Medicine, Hospital General Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain aut Garcia Angel Department of Pathology, Hospital General Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain aut Xercavins Jordi Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain aut Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 482-489 1068-9265 18:2<482 2011 18 10434 https://doi.org/10.1245/s10434-010-1320-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1320-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Gil-Moreno Antonio Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain aut NATIONALLICENCE 700 1- Franco-Camps Silvia Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain aut NATIONALLICENCE 700 1- Cabrera Silvia Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain aut NATIONALLICENCE 700 1- Pérez-Benavente Assumpció Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain aut NATIONALLICENCE 700 1- Martínez-Gómez Xavier Service of Epidemiology and Preventive Medicine, Hospital General Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain aut NATIONALLICENCE 700 1- Garcia Angel Department of Pathology, Hospital General Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain aut NATIONALLICENCE 700 1- Xercavins Jordi Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 482-489 1068-9265 18:2<482 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer