Comparison of retroperitoneal and transperitoneal surgical routes in laparoscopic nodal staging for locally advanced cervical cancers (FIGO IB3-IVA).

Female Humans Laparoscopy Lymph Node Excision Lymph Nodes / pathology Neoplasm Staging Retrospective Studies Uterine Cervical Neoplasms / pathology

Journal

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
ISSN: 1532-2157
Titre abrégé: Eur J Surg Oncol
Pays: England
ID NLM: 8504356

Informations de publication

Date de publication:
09 2022
Historique:
received: 14 01 2022
revised: 25 04 2022
accepted: 06 05 2022
pubmed: 2 6 2022
medline: 4 10 2022
entrez: 1 6 2022
Statut: ppublish

Résumé

This study compares morbidity and mortality associated with retroperitoneal and transperitoneal para-aortic lymphadenectomy (PAAL) for pretherapeutic nodal staging of locally advanced cervical cancers (FIGO IB3-IVA). Pre-, per- and postoperative data of patients treated for locally advanced stage cervical cancer between 1999 and 2018 in 12 French referral centers (FRANCOGYN Study Group) were retrospectively collected. The study was conducted using a sample of 448 patients, of whom 223 (49,8%) underwent retroperitoneal (group 1) and 225 (50,2%) had transperitoneal PAAL (group 2). No differences were noted concerning clinical and histological characteristics between the two groups. Among these 448 patients, 23 (5,1%) had an intraoperative complication (9 (2,0%) in group 1 and 14 (3,1%) in group 2, p = 0.28) and 47 (10,5%) had a postoperative complication (22 (4,9%) in group 1 and 25 (5,6%) in group 2, p = 0.44), only one of which required revision surgery but the patient died. The length of hospital stay was significantly shorter in group 1 than in group 2 (3.97 versus 4.88 days, p < 0.001). There was no significant difference in mortality between the two groups; 34 of 223 patients in group 1 (15.3%) and 40 of 225 patients in group 2 (15.6%) died (HR = 0.968, 95% CI [0.591-1.585]). There was no significant difference in recurrence-free or overall survival between the two groups. Retroperitoneal PAAL appears as a valuable and safety surgical route for nodal staging in locally advanced cervical cancer compared with standard transperitoneal PAAL.

Sections du résumé

BACKGROUND
This study compares morbidity and mortality associated with retroperitoneal and transperitoneal para-aortic lymphadenectomy (PAAL) for pretherapeutic nodal staging of locally advanced cervical cancers (FIGO IB3-IVA).
METHODS
Pre-, per- and postoperative data of patients treated for locally advanced stage cervical cancer between 1999 and 2018 in 12 French referral centers (FRANCOGYN Study Group) were retrospectively collected.
RESULTS
The study was conducted using a sample of 448 patients, of whom 223 (49,8%) underwent retroperitoneal (group 1) and 225 (50,2%) had transperitoneal PAAL (group 2). No differences were noted concerning clinical and histological characteristics between the two groups. Among these 448 patients, 23 (5,1%) had an intraoperative complication (9 (2,0%) in group 1 and 14 (3,1%) in group 2, p = 0.28) and 47 (10,5%) had a postoperative complication (22 (4,9%) in group 1 and 25 (5,6%) in group 2, p = 0.44), only one of which required revision surgery but the patient died. The length of hospital stay was significantly shorter in group 1 than in group 2 (3.97 versus 4.88 days, p < 0.001). There was no significant difference in mortality between the two groups; 34 of 223 patients in group 1 (15.3%) and 40 of 225 patients in group 2 (15.6%) died (HR = 0.968, 95% CI [0.591-1.585]). There was no significant difference in recurrence-free or overall survival between the two groups.
CONCLUSION
Retroperitoneal PAAL appears as a valuable and safety surgical route for nodal staging in locally advanced cervical cancer compared with standard transperitoneal PAAL.

Identifiants

DOI: 10.1016/j.ejso.2022.05.005 PMID: 35643576
pubmed: 35643576
pii: S0748-7983(22)00430-9
doi: 10.1016/j.ejso.2022.05.005
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2061-2067

Informations de copyright

Copyright © 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest This work received no funding. There was no commercial interest that any author may have in the subject of study and the source of any financial or material support.

Auteurs

Marie Pécout (M)

Gynaecological Surgery Department, Jeanne de Flandre Hospital, University Hospital of Lille, Avenue Eugène Avinée, 59007, Lille Cedex, France. Electronic address: marie.pecout@chru-lille.fr.

Jérôme Phalippou (J)

Gynaecological Surgery Department, Jeanne de Flandre Hospital, University Hospital of Lille, Avenue Eugène Avinée, 59007, Lille Cedex, France.

Henri Azaïs (H)

AP-HP.CUP, Department of gynecological and breast cancer surgery, Georges-Pompidou European Hospital, Paris, France.

Lobna Ouldamer (L)

Department of Gynaecology. CHRU de Tours. Hôpital Bretonneau. INSERM Unit, 1069, 2 boulevard Tonnellé 37044, Tours, France.

Pierre Adrien Bolze (PA)

Department of Gynaecologic and Oncologic Surgery and Obstetrics, Centre Hospitalier Universitaire Lyon Sud, Hospices Civils de Lyon, Université Lyon 1, France.

Marcos Ballester (M)

Department of Gynaecologic and Breast Surgery, Groupe Hospitalier Diaconesses Croix Saint Simon, 125 rue d'Avron, 75020, Paris, France.

Cyrille Huchon (C)

APHP. Service de gynécologie & obstétrique, GH Saint-Louis Lariboisière-Fernand Widal, Hôpital Lariboisière, Université de Paris, 2, rue Ambroise Paré, 75010, Paris, France.

Camille Mimoun (C)

APHP. Service de gynécologie & obstétrique, GH Saint-Louis Lariboisière-Fernand Widal, Hôpital Lariboisière, Université de Paris, 2, rue Ambroise Paré, 75010, Paris, France.

Cherif Akladios (C)

Department of Gynecologic Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.

Lise Lecointre (L)

Department of Gynecologic Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.

Emilie Raimond (E)

Department of Obstetrics and Gynaecology, Alix de Champagne Institute, Centre Hospitalier Universitaire, 45 rue Cognacq-Jay, 51092, Reims, France.

Olivier Graesslin (O)

Department of Obstetrics and Gynaecology, Alix de Champagne Institute, Centre Hospitalier Universitaire, 45 rue Cognacq-Jay, 51092, Reims, France.

Xavier Carcopino (X)

Department of Obstetrics and Gynaecology, Hôpital Nord, APHM, Aix-Marseille University (AMU), Univ Avignon, CNRS, IRD, IMBE UMR 7263, 13397, Marseille, France.

Vincent Lavoué (V)

Department of Gynaecology, CHU de Rennes, France; INSERM, 1242, COSS, Rennes, Université de Rennes 1, France.

Sofiane Bendifallah (S)

Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Faculté de Médecine Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France.

Cyril Touboul (C)

Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Faculté de Médecine Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France.

Yohan Dabi (Y)

Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Faculté de Médecine Sorbonne Université, Institut Universitaire de Cancérologie (IUC), France.

Geoffroy Canlorbe (G)

Department of Gynecologic and Breast Surgery and Oncology, Hôpital la Pitié Salpétrière, AP-HP, Paris, France.

Martin Koskas (M)

Department of Gynaecology and Obstetrics, Hôpital Bichat, AP-HP, France.

Pauline Chauvet (P)

Department of Gynaecology and Obstetrics, CHU de Clermont Ferrand, France.

Pierre Collinet (P)

Gynaecological Surgery Department, Jeanne de Flandre Hospital, University Hospital of Lille, Avenue Eugène Avinée, 59007, Lille Cedex, France.

Yohan Kerbage (Y)

Gynaecological Surgery Department, Jeanne de Flandre Hospital, University Hospital of Lille, Avenue Eugène Avinée, 59007, Lille Cedex, France.

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