Stage-adjusted chemoradiation in cervical cancer after transperitoneal laparoscopic staging.
OBJECTIVE
To evaluate the impact of transperitoneal laparoscopic staging on choice of subsequent therapy including oncologic outcome and toxicity of chemoradiation after surgical staging.


METHODS
101 patients with cervical cancer FIGO IB1-IVB underwent chemoradiation after transperitoneal laparoscopic staging.


RESULTS
101 women (FIGO IB1-IVB) were laparoscopically staged. In 68/101 patients, pelvic and/or paraaortic lymph node metastases were confirmed histologically. Only 17/101 patients (17%) retained their original FIGO stage after laparoscopy. Laparoscopic staging and chemoradiation were well tolerated. Laparoscopic debulking of tumor-involved lymph nodes resulted in significantly improved overall survival.


CONCLUSIONS
In patients with cervical cancer, laparoscopic staging led to an upstaging of 83% of cases with significant impact on therapeutic strategies. Nodal debulking prior to chemoradiation improves the prognosis of node positive women. Pretherapeutic laparoscopic staging should be the basis of the primary chemoradiation in patients with cervical cancer.
Marnitz
Simone
S
Department of Radiooncology, Charité Berlin, Germany. simone.marnitz@@charite.de
Köhler
Christhardt
C
Roth
Christina
C
Füller
Jürgen
J
Bischoff
Annett
A
Wendt
Thomas
T
Schneider
Achim
A
Budach
Volker
V
D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001918:Brachytherapy; D016190:Carboplatin / Q000008:administration & dosage; D018196:Carcinoma, Adenosquamous / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology / Q000532:radiotherapy*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D012007:Rectum / Q000473:pathology; D015996:Survival Rate; D001743:Urinary Bladder / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery
D016190:Carboplatin; D002945:Cisplatin; D005472:Fluorouracil