Surgical Outcomes of Laparoscopic Pelvic Lymph Node Debulking during Staging Aortic Lymphadenectomy in Locally Advanced Cervical Cancer: A Multicenter Study

Few studies have evaluated laparoscopic pelvic lymph node (PLN) debulking during staging aortic lymphadenectomy in locally advanced cervical cancer (LACC). It allows us to know the lymph node status and facilitates the action of chemoradiotherapy (CRT) by reducing tumor burden. We evaluated its feas...

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Bibliographic Details
Published in:Cancers 2022-04, Vol.14 (8), p.1974
Main Authors: Díaz-Feijoó, Berta, Acosta, Úrsula, Torné, Aureli, Gil-Ibáñez, Blanca, Hernández, Alicia, Domingo, Santiago, Bradbury, Melissa, Gil-Moreno, Antonio
Format: Article
Language:English
Subjects:
Aorta
Body fat
Cancer therapies
Cervical cancer
Chemoradiotherapy
Clinical medicine
Complications
Dissection
Hospitals
Laparoscopy
Lymph nodes
Lymphatic system
Magnetic resonance imaging
Metastases
Metastasis
Morbidity
Patients
Postoperative
Surgery
Surgical outcomes
Surgical techniques
Tumors
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Summary:Few studies have evaluated laparoscopic pelvic lymph node (PLN) debulking during staging aortic lymphadenectomy in locally advanced cervical cancer (LACC). It allows us to know the lymph node status and facilitates the action of chemoradiotherapy (CRT) by reducing tumor burden. We evaluated its feasibility and compared the perioperative morbidity and the time to CRT with a control group. This was a multicenter retrospective study of patients with LACC FIGO stage IIIC1r who were recipients of CRT. We compared two cohorts: group 1, which consisted of 164 patients with surgical staging by laparoscopic aortic lymphadenectomy and PLN debulking, and group 2, which consisted of 111 patients with aortic lymphadenectomy alone. Excision of the bulky nodes was possible in all patients in group 1 except for one. Surgery lasted a median of 82 min longer in group 1 but there was no greater intraoperative bleeding or increased hospital stay. There were no significant differences in intraoperative or postoperative complications between the groups. A significantly shorter time from surgery to the start of RT was observed in group 1. It is feasible to perform laparoscopic PLN debulking in the same procedure as the staging aortic lymphadenectomy in LACC without increasing surgical or postoperative complications and without delaying the start of CRT compared to single aortic lymphadenectomy.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers14081974