title: An update of laparoscopy in cervical cancer staging: is it a useful procedure?
abstract: OBJECTIVE
  It was the aim of this study to report on the role of laparoscopic staging in a large series of locally advanced cervical cancer (LACC) patients and its impact on prognosis.
  
  
  METHODS
  Consecutive patients with LACC were considered for surgical staging: gynecological examination, cystoscopy and laparoscopy with peritoneal biopsies and peritoneal fluid cytology.
  
  
  RESULTS
  Between February 2000 and September 2010, a total of 167 women were evaluated. In 5 patients, laparoscopy could not be performed. One hundred and sixty-two patients had correct laparoscopic staging: 49 International Federation of Gynecology and Obstetrics (FIGO) stage IB-IIA (>4 cm), 67 IIB, 39 III, and 7 IVA. Abdominal spread was found in 33 cases (20%). There was a minor laparoscopy complication rate of 1%. We found a significant difference in the distribution of peritoneal spread for tumor grade and FIGO stage (p = 0.01 and p < 0.0001, respectively), whereas no statistically significant difference for the histological type was found [p = not significant (NS)]. The median follow-up was 80 months (range 4-144). The median overall survival was 65 months. The patients without abdominal spread did not benefit from a significantly longer survival (median overall survival of 59 vs. 70 months; p = NS).
  
  
  CONCLUSIONS
  Laparoscopic staging in cervical cancer is a safe and feasible technique but it does not modify the prognosis of LACC patients.
authors.affiliation: Department of Gynecology and Obstetrics, Sapienza University of Rome, Rome, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Benedetti Panici
authors.forename: Giorgia
authors.initials: G
authors.lastname: Perniola
authors.forename: Federica
authors.initials: F
authors.lastname: Tomao
authors.forename: Margherita
authors.initials: M
authors.lastname: Fischetti
authors.forename: Delia
authors.initials: D
authors.lastname: Savone
authors.forename: Violante
authors.initials: V
authors.lastname: Di Donato
authors.forename: Roberto
authors.initials: R
authors.lastname: Angioli
authors.forename: Ludovico
authors.initials: L
authors.lastname: Muzii
mesh_terms: D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D010535:Laparoscopy / Q000191:economics / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D010537:Peritoneum / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology*