TY - JOUR
T1 - Para-aortic lymph node metastases in locally advanced cervical cancer: Comparison between surgical staging and imaging
AU - Vandeperre, Armin
AU - van Limbergen, Erik
AU - Leunen, Karin
AU - Moerman, Philippe
AU - Amant, Frédéric
AU - Vergote, Ignace
PY - 2015
Y1 - 2015
N2 - Objective. Compare surgical staging with imaging (PET-CT, PET or CT) of the para-aortic lymph nodes (PAOLN) in locally advanced cervical cancer (LACC). Methods. Monocentric retrospective study of 336 patients with cervical cancer FIGO stage IB2-IVA. All patients underwent staging of the PAOLN using imaging by PET-CT, PET or CT. Two hundred and four patients with normal or not overtly malignant PAOLN on imaging underwent surgical PAOLN staging up to the inferior mesenteric artery (189 endoscopy and 15 laparotomy). Results. The patients were divided into 4 groups: 16 with positive surgical staging and negative PAOLN imaging (sPAOLN +), 172 negative surgical staging (sPAOLN -), 20 positive imaging without surgical staging (iPAOLN +) and 128 negative imaging without surgical staging (iPAOLN -). Median operative time of staging was 70 (40-160) min and median number of removed PAOLN was 5 (0-24). Operative complications were 10 peroperative bleedings, 2 ureteral traumas, 1 carbon dioxide retention and 1 retroperitoneal abscess. The median follow-up was 31 (1-218) months. Overall survival at 2 years was for sPAOLN +, sPAOLN -, iPAOLN +, and iPAOLN-40%, 83%, 58%, and 69%, respectively (p <0.001 for sPAOLN + and iPAOLN + versus sPAOLN- and iPAOLN -). The most frequent site of recurrence was distant LN metastases (outside the pelvic and PAO area) (36%) for sPAOLN +. For sPAOLN -, iPAOLN +, and iPAOLN - the most frequent site of recurrence was the cervix (27%, 66% and 26%, respectively). Conclusion. Despite negative imaging, PAOLN metastases were present in 8% at surgical staging. Overall survival is significantly influenced by the presence of PAOLN metastases. (C) 2015 Elsevier Inc. All rights reserved
AB - Objective. Compare surgical staging with imaging (PET-CT, PET or CT) of the para-aortic lymph nodes (PAOLN) in locally advanced cervical cancer (LACC). Methods. Monocentric retrospective study of 336 patients with cervical cancer FIGO stage IB2-IVA. All patients underwent staging of the PAOLN using imaging by PET-CT, PET or CT. Two hundred and four patients with normal or not overtly malignant PAOLN on imaging underwent surgical PAOLN staging up to the inferior mesenteric artery (189 endoscopy and 15 laparotomy). Results. The patients were divided into 4 groups: 16 with positive surgical staging and negative PAOLN imaging (sPAOLN +), 172 negative surgical staging (sPAOLN -), 20 positive imaging without surgical staging (iPAOLN +) and 128 negative imaging without surgical staging (iPAOLN -). Median operative time of staging was 70 (40-160) min and median number of removed PAOLN was 5 (0-24). Operative complications were 10 peroperative bleedings, 2 ureteral traumas, 1 carbon dioxide retention and 1 retroperitoneal abscess. The median follow-up was 31 (1-218) months. Overall survival at 2 years was for sPAOLN +, sPAOLN -, iPAOLN +, and iPAOLN-40%, 83%, 58%, and 69%, respectively (p <0.001 for sPAOLN + and iPAOLN + versus sPAOLN- and iPAOLN -). The most frequent site of recurrence was distant LN metastases (outside the pelvic and PAO area) (36%) for sPAOLN +. For sPAOLN -, iPAOLN +, and iPAOLN - the most frequent site of recurrence was the cervix (27%, 66% and 26%, respectively). Conclusion. Despite negative imaging, PAOLN metastases were present in 8% at surgical staging. Overall survival is significantly influenced by the presence of PAOLN metastases. (C) 2015 Elsevier Inc. All rights reserved
U2 - https://doi.org/10.1016/j.ygyno.2015.05.021
DO - https://doi.org/10.1016/j.ygyno.2015.05.021
M3 - Article
C2 - 26007204
SN - 0090-8258
VL - 138
SP - 299
EP - 303
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 2
ER -