Experiences of pretreatment laparoscopic surgical staging in patients with locally advanced cervical cancer: results of a prospective study.
OBJECTIVE
To prospectively evaluate the feasibility, safety, and survival of laparoscopic surgical staging in patients with locally advanced cervical cancer.


METHODS
From Oct 2001 to Jul 2006, a total of 83 consecutive patients were eligible for inclusion and underwent laparoscopic surgical staging.


RESULTS
Three patients with intraoperative great vessel injury and 1 patient in whom the colpotomizer was unable to be inserted were excluded. Laparoscopic surgical staging was feasible in 95.2% (79/83). Immediate postoperative complications were noted in 12 (15.2%) patients. Prolonged complications directly related to operative procedures numbered 2 (2.5%), and were trocar site metastases. The mean time from surgery to the start of radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) was 11 (5-35) days. All patients tolerated the treatment well and completed scheduled RT or CCRT without disruption of treatment and additional admission. The rate of modification of the radiation field after surgical staging was 8.9% (7/79). Five-year progression-free survival and overall survival (OS) rates were 79% and 89%, respectively. The OS of patients with microscopic lymph node metastases, which were fully resected, were comparable to those of patients without lymph node metastasis. However, the OS of patients with macroscopic lymph node metastases that were fully resected were poorer compared with those of patients without lymph node metastasis.


CONCLUSIONS
Pretreatment laparoscopic surgical staging is a feasible and safe treatment modality. However the survival benefit of debulking lymph nodes or full lymph node dissection is not clear.
Lim
Myong Cheol
MC
Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
Bae
Jaeman
J
Park
Jeong-Yoel
JY
Lim
Soyi
S
Kang
Sokbom
S
Seo
Sang-Soo
SS
Kim
Joo-Yong
JY
Rho
Ju-Won
JW
Park
Sang-Yoon
SY