Perioperative morbidity and rate of upstaging after laparoscopic staging for patients with locally advanced cervical cancer: results of a prospective randomized trial

Morbidity of Staging Inframesenteric Paraaortic Lymphadenectomy in Locally Advanced Cervical Cancer Compared With Infrarenal Lymphadenectomy

“…Indeed, in the literature, the rates ranged from 7% to 15% 7,8,11,20,23Y25 or even 25% 19 for perioperative complications and 8% to 27% for lymphocysts. 8,11,24,25 We considered all of the recorded complications, especially grade I complications, for 9 patients in the IM-LND group and 6 patients in the IR-LND group unlike other studies. 11 Lymphocyst is a common complication of paraaortic LND after extraperitoneal surgery, which is asymptomatic most of the time.…”

“…7 The most appropriate management approach is generally determined by a multidisciplinary committee after performing paraaortic staging using positron emission tomographyYcomputed tomography (PET-CT), and if the result is negative at this level, by using a laparoscopic approach before chemoradiation. 8 If lymphadenectomy is necessary, it is because of the low sensitivity of PET-CT in the detection of low-volume nodal metastasis (nearly 34% for microscopic metastases 9 ) despite its high specificity and good rate of detection of paraaortic disease. 10,11 Paraaortic lymphadenectomy is defined by the removal of nodes located in the common iliac nodes up to the left renal vein.…”

Incidence of Histologically Proven Pelvic and Para-Aortic Lymph Node Metastases and Rate of Upstaging in Patients with Locally Advanced Cervical Cancer: Results of a Prospective Randomized Trial

“…The best oncological results of >50% overall survival can be obtained after complete para-aortic LND including debulking of enlarged lymph nodes in combination with modern radiooncology techniques of EFRT in patients with histologically confirmed para-aortic metastases [24,48] . The surgical arm of the Uterus-11 study met these criteria.…”

“…The surgical arm of the Uterus-11 study met these criteria. Unfortunately, despite excellent para-aortic and local control, para-aortic lymph node metastases appear to be a surrogate parameter for a high risk of distant metastases in these patients [48] .…”

“…However, this approach is associated with a considerable rate of overtreatment and morbidity and remains controversial [45][46][47] . If extended-field radiation therapy (EFRT) is only applied in patients with histologically proven para-aortic metastases using modern radiation techniques, 5-year survival rates up to 54% can be achieved [48] .…”