title: Stage-adjusted chemoradiation in cervical cancer after transperitoneal laparoscopic staging.
abstract: 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.
authors.affiliation: Department of Radiooncology, Charité Berlin, Germany. simone.marnitz@@charite.de
authors.forename: Simone
authors.initials: S
authors.lastname: Marnitz
authors.forename: Christhardt
authors.initials: C
authors.lastname: Köhler
authors.forename: Christina
authors.initials: C
authors.lastname: Roth
authors.forename: Jürgen
authors.initials: J
authors.lastname: Füller
authors.forename: Annett
authors.initials: A
authors.lastname: Bischoff
authors.forename: Thomas
authors.initials: T
authors.lastname: Wendt
authors.forename: Achim
authors.initials: A
authors.lastname: Schneider
authors.forename: Volker
authors.initials: V
authors.lastname: Budach
mesh_terms: 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
chemical_list: D016190:Carboplatin; D002945:Cisplatin; D005472:Fluorouracil