Laparoscopic retroperitoneal para‐aortic lymph node biopsy in advanced cervical cancer with pelvic lymph node metastases: A single‐center prospective study
| Autor: | Tomoaki Ikeda, Michiko Kaneda, Tsuyoshi Matsumoto, Eiji Kondo, Masafumi Nii, Kenta Yoshida, Shintaro Maki, Toru Hirata |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Biopsy medicine.medical_treatment Uterine Cervical Neoplasms Standardized uptake value Metastasis Positron Emission Tomography Computed Tomography medicine Humans Prospective Studies Stage (cooking) Prospective cohort study Lymph node Neoplasm Staging Retrospective Studies Cervical cancer medicine.diagnostic_test business.industry Obstetrics and Gynecology medicine.disease Radiation therapy medicine.anatomical_structure Lymphatic Metastasis Lymph Node Excision Female Laparoscopy Lymph Nodes Radiology business |
| Zdroj: | Journal of Obstetrics and Gynaecology Research. 47:3951-3957 |
| ISSN: | 1447-0756 1341-8076 |
| Popis: | Aim Extended-field concurrent chemoradiation therapy (Ex-CCRT) has been widely used for para-aortic lymph node (PAN) metastases confirmed by radiographic assessment without surgical exploration. The objective of this prospective study was to evaluate the clinical value of laparoscopic retroperitoneal PAN biopsy in locally advanced cervical cancer (LACC) with pelvic lymph node (PLN) metastases. Methods From May 2017 to March 2020, stage IIB-IIIB cervical cancer patients who were diagnosed with PLN metastasis using positron emission tomography-computed tomography (PET-CT) with maximum standardized uptake value (SUVmax) ≥2.0 underwent laparoscopic retroperitoneal PAN biopsy. The radiation fields were extended to PAN areas with pathological metastases. Results Fourteen patients were diagnosed with cervical squamous cell carcinoma of the International Federation of Gynecology and Obstetrics (FIGO) stage IIB (n = 7) and IIIB (n = 7). The median operating time was 138 min (range, 104-184 min). The median number of harvested PANs was 19 (range, 6-36). Three patients were positive for PAN metastasis on histological analysis. In this study, the sensitivity and specificity of PET-CT were 66.7% and 90.9%, respectively. Conclusion Our study is characterized by the use of more appropriate eligibility criteria for LACC with PLN metastases. Our results revealed that laparoscopic retroperitoneal PAN biopsy may be a useful approach to determine the radiation field for PANs during standard radiotherapy planning. |
| Databáze: | OpenAIRE |
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