Díaz-Feijoó Berta, Acosta Úrsula, Torné Aureli, Gil-Ibáñez Blanca, Hernández Alicia, Domingo Santiago, Bradbury Melissa, Gil-Moreno Antonio
Gynecology Oncology Unit, Institute Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clínic de Barcelona, 08036 Barcelona, Spain.
Institut d 'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine, University of Barcelona, 08036 Barcelona, Spain.
Cancers (Basel). 2022 Apr 13;14(8):1974. doi: 10.3390/cancers14081974.
Few studies have evaluated laparoscopic pelvic lymph node (PLN) debulking during staging aortic lymphadenectomy in locally advanced cervical cancer (LACC). It allows us to know the lymph node status and facilitates the action of chemoradiotherapy (CRT) by reducing tumor burden. We evaluated its feasibility and compared the perioperative morbidity and the time to CRT with a control group.
This was a multicenter retrospective study of patients with LACC FIGO stage IIIC1r who were recipients of CRT. We compared two cohorts: group 1, which consisted of 164 patients with surgical staging by laparoscopic aortic lymphadenectomy and PLN debulking, and group 2, which consisted of 111 patients with aortic lymphadenectomy alone.
Excision of the bulky nodes was possible in all patients in group 1 except for one. Surgery lasted a median of 82 min longer in group 1 but there was no greater intraoperative bleeding or increased hospital stay. There were no significant differences in intraoperative or postoperative complications between the groups. A significantly shorter time from surgery to the start of RT was observed in group 1.
It is feasible to perform laparoscopic PLN debulking in the same procedure as the staging aortic lymphadenectomy in LACC without increasing surgical or postoperative complications and without delaying the start of CRT compared to single aortic lymphadenectomy.
很少有研究评估在局部晚期宫颈癌（LACC）分期性主动脉淋巴结清扫术中进行腹腔镜盆腔淋巴结（PLN）减瘤术的情况。它能让我们了解淋巴结状态，并通过减轻肿瘤负荷来促进放化疗（CRT）的实施。我们评估了其可行性，并将围手术期发病率以及开始CRT的时间与对照组进行比较。
这是一项对接受CRT的LACC FIGO IIIC1r期患者的多中心回顾性研究。我们比较了两个队列：第1组由164例行腹腔镜主动脉淋巴结清扫术及PLN减瘤术进行手术分期的患者组成，第2组由111例仅行主动脉淋巴结清扫术的患者组成。
第1组除1例患者外，所有患者均成功切除肿大淋巴结。第1组手术时间中位数长82分钟，但术中出血未增多，住院时间也未延长。两组之间术中或术后并发症无显著差异。第1组从手术到开始放疗的时间明显更短。
在LACC中，与单纯主动脉淋巴结清扫术相比，在分期性主动脉淋巴结清扫术的同一手术中进行腹腔镜PLN减瘤术是可行的，不会增加手术或术后并发症，也不会延迟CRT的开始。
