Laparoscopic sentinel lymph node dissection followed by open radical hysterectomy for early stage cervical cancer: A pilot study.


Journal

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
ISSN: 1879-3479
Titre abrégé: Int J Gynaecol Obstet
Pays: United States
ID NLM: 0210174

Informations de publication

Date de publication:
Feb 2021
Historique:
received: 10 04 2020
revised: 19 06 2020
accepted: 16 09 2020
pubmed: 23 9 2020
medline: 13 4 2021
entrez: 22 9 2020
Statut: ppublish

Résumé

To propose a treatment algorithm, after the LACC trial, of laparoscopic sentinel lymph node biopsy with frozen section, followed by immediate open radical hysterectomy in node-negative cases, for early stage cervical cancer. We retrospectively collected all cases of cervical cancer that were surgically treated between 2019-2020. In all cases, surgery began with laparoscopic sentinel lymph node biopsy ± ovarian transposition. Node-negative cases continued with open radical hysterectomy. In node-positive cases, surgery was discontinued, sparing the patient a laparotomy incision. Nine patients with cervical cancer were referred for surgery. Laparoscopic bilateral lymph node identification was achieved in all. In two cases, sentinel lymph nodes were positive for metastatic cancer and surgery was discontinued. For the other seven, node-negative patients, open radical hysterectomy was completed. Four patients had laparoscopic ovarian transposition. There were no cases where nodes were negative on frozen section but positive on final pathology. Laparoscopic sentinel lymph node biopsy before open radical hysterectomy may spare a considerable number of laparotomies on the one hand and bi-modal treatment with surgery and radiation on the other, for node-positive patients. The oncological safety of this approach is yet to be determined.

Identifiants

pubmed: 32961587
doi: 10.1002/ijgo.13383
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

183-187

Informations de copyright

© 2020 International Federation of Gynecology and Obstetrics.

Références

Ramirez PT, Frumovitz M, Pareja R, et al. Minimally invasive versus abdominal radical hysterectomy for cervical cancer. N Engl J Med. 2018;379:1895-1904.
Melamed A, Margul DJ, Chen L, et al. Survival after minimally invasive radical hysterectomy for early-stage cervical cancer. N Engl J Med. 2018;379:1905-1914.
Paik ES, Lim MC, Kim MH, et al. Comparison of laparoscopic and abdominal radical hysterectomy in early stage cervical cancer patients without adjuvant treatment: Ancillary analysis of a Korean Gynecologic Oncology Group Study (KGOG 1028). Gynecol Oncol. 2019;154:547-553.
Cusimano MC, Baxter NN, Gien LT, et al. Impact of surgical approach on oncologic outcomes in women undergoing radical hysterectomy for cervical cancer. Am J Obstet Gynecol. 2019;221:619.e1-619.e24.
Cibula D, Pötter R, Planchamp F, et al. The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology Guidelines for the Management of Patients With Cervical Cancer. Int J Gynecol Cancer. 2018;28:641-655.
NCCN clinical practice guidlines in oncology. Cervical cancer. Version 1, 2020. https://www.nccn.org/professionals/physician_gls/pdf/cervical.pdf. Accessed January 14, 2020.
Bats AS, Buénerd A, Querleu D, et al. Diagnostic value of intraoperative examination of sentinel lymph node in early cervical cancer: A prospective, multicenter study. Gynecol Oncol. 2011;123:230-235.
Salvo G, Ramirez PT, Levenback CF, et al. Sensitivity and negative predictive value for sentinel lymph node biopsy in women with early-stage cervical cancer. Gynecol Oncol. 2017;145:96-101.
Cormier B, Diaz JP, Shih K, et al. Establishing a sentinel lymph node mapping algorithm for the treatment of early cervical cancer. Gynecol Oncol. 2011;122:275-280.
Rychlik A, Angeles MA, Migliorelli F, et al. Frozen section examination of sentinel lymph nodes can be used as a decisional tool in the surgical management of early cervical cancer. Int J Gynecol Cancer. 2020;30:358-363.
Tax C, Rovers MM, de Graaf C, Zusterzeel PLM, Bekkers RLM. The sentinel node procedure in early stage cervical cancer, taking the next step; a diagnostic review. Gynecol Oncol. 2015;139:559-567.
Lécuru F, Mathevet P, Querleu D, et al. Bilateral negative sentinel nodes accurately predict absence of lymph node metastasis in early cervical cancer: results of the SENTICOL study. J Clin Oncol. 2011;29:1686-1691.

Auteurs

Nadav Michaan (N)

Gynecologic Oncology, Department of Obstetrics and Gynecology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Ido Laskov (I)

Gynecologic Oncology, Department of Obstetrics and Gynecology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Asaf Aizic (A)

Department of Pathology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Oded Brautbar (O)

Department of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Dan Grisaru (D)

Gynecologic Oncology, Department of Obstetrics and Gynecology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

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