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Minimally Invasive Gynecology pp 247–255Cite as

Laparoscopic Operative Staging in Cervical Cancer

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Abstract

Cancer of the uterine cervix is still one of the most common cancers among women worldwide with approximately 530,000 new cases and 275,000 deaths in 2008 [1]. Cervical cancer classically occurs in young patients with a mean age of 45 years, resulting in a potential loss of 26 years of life per affected individual [1, 2]. Unfortunately, about 60% of these cases are diagnosed with advanced disease and are no longer candidates for primary curative surgery. In countries with high resources, total incidence of invasive cervical cancer is decreasing due to effective screening with a shift toward earlier stages of disease [2]. However, percentage of patients with FIGO stages ≥IIB stagnates over years in many countries. This is probably due to women who never made use of screening programs. In Germany percentages of stages II, III, and IV are 25%, 8%, and 6% with 5-year survival of 71%, 51%, and 16%, respectively [3]. Between 2005 and 2008 in Beijing, distribution of FIGO stages II, III, and IV was 26%, 18% and 6%, respectively, mainly in unemployed women and housewives, farmers, and urban low-income people [4]. There is also a higher risk for cervical cancer for older and/or uninsured people in the USA [5]. Socioeconomic situation influences probability for cervical cancer with higher risk for short-educated, older women living without partners in Denmark, as demonstrated by Ibfelt et al. [6]. Therefore therapy of cervical cancer in locally advanced stage is still a relevant problem.

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References

  1. Arbyn M, Castellsaque X, de Sanjose S, Bruni L, Saraiya M, Bray F, Ferlay J. Worldwide burden of cervical cancer in 2008. Ann Oncol. 2011;12:2675–86.

    Google Scholar 

  2. Covens A, Rosen B, Murphy J, et al. Changes in the demographics and perioperative care of stage IA2/IB1 cervical cancer over the past 16 years. Gynecol Oncol. 2001;81:133–7.

    CAS  PubMed  Google Scholar 

  3. Krebs in Deutschland 2009/2010. 9. Ausgabe. Robert Koch-Institut (Hrsg) und die Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V. (Hrsg). Berlin, 2013.

    Google Scholar 

  4. Wang T, Wu MH, Wu YM, Zhang WY. A population-based study of invasive cervical cancer patients in Beijing: 1993-2008. Chin Med J. 2015;128:3298–304.

    PubMed  PubMed Central  Google Scholar 

  5. Fedewa SA, Cokkinides V, Virgo K, Bandi P, Saslow D, Ward EM. Association of insurance status and age with cervical cancer stage at diagnosis: national cancer database, 2000–2007. Am J Public Health. 2012;102:1782–90.

    PubMed  PubMed Central  Google Scholar 

  6. Ibfelt E, Kjaer S, Johansen C, Hogdall C, Steding-Jessen M, Frederiksen K, Frederiksen BL, Osler M, Dalton S. Socioeconomic position and stage of cervical cancer in Danish women diagnosed 2005 to 2009. Cancer Epidemiol Biomark Prev. 2012;21(5):835–42.

    Google Scholar 

  7. Quinn MA, Benedet JL, Odicino F, Maisonneuve P, Beller U, Creasman WT, Heintz AP, Ngan HY, Pecorelli S. Carcinoma of the cervix uteri. FIGO 26th Annual report on the results of treatment in Gynecological Caner. Int J Gynaecol Obstet. 2006;95(Suppl 1):S43–103.

    PubMed  Google Scholar 

  8. http://www.nccn.org/professionals/physician_gls/f_guidelines.

  9. Expert Panel on Radiation Oncology-Gynecology, Kidd E, Moore D, Varia MA, Gaffney DK, Elshaikh MA, Erickson B, Jhingran A, Lee LJ, Mayr NA, Puthawala AA, Rao GG, Small W Jr, Wahl AO, Wolfson AH, Yashar CM, Yuh W, Cardenes HR. ACR Appropriateness Criteria® management of locoregionally advanced squamous cell carcinoma of the vulva. Am J Clin Oncol. 2013;36:415–22.

    Google Scholar 

  10. Hricak H, Gatsonis C, Chi DS, Amendola MA, Brandt K, Schwartz LH, Koelliker S, Siegelman ES, Brown JJ, McGhee RB Jr, Iyer R, Vitellas KM, Snyder B, Long HJ 3rd, Fiorica JV, Mitchell DG, American College of Radiology Imaging Network 6651; Gynecologic Oncology Group 183. Role of imaging in pretreatment evaluation of early invasive cervical cancer: results of the intergroup study American College of Radiology Imaging Network 6651- Gynecologic Oncologic Group 183. J Clin Oncol. 2005;23:9329–37.

    PubMed  Google Scholar 

  11. Choi HJ, Ju W, Myung SK, et al. Diagnostic performance of computer tomography, magnetic resonance imaging, and positron emission tomography or positron emission tomography/computer tomography for detection of metastatic lymph nodes in patients with cervical cancer: meta-analysis. Cancer Sci. 2010;101:1471–9.

    CAS  PubMed  Google Scholar 

  12. Leblanc E, Gauthier H, Querleu D, Ferron G, Zerdoud S, Morice P, Uzan C, Lumbroso S, Lecuru F, Bats AS, Ghazzar N, Bannier M, Houvenaeghel G, Brenot-Rossi I, Narducci F. Accuracy of 18-Fluoro-2-deoxy-D: -glucose positron emission tomography in the pretherapeutic detection of occult para-aortic node involvement in patients with a locally advanced cervical carcinoma. Ann Surg Oncol. 2011;18:2302–9.

    CAS  PubMed  Google Scholar 

  13. Ramirez PT, Jhingran A, Macapinlac HA, Euscher ED, Munsell MF, Coleman RL, Soliman PT, Schmeler KM, Frumovitz M, Ramondetta LM. Laparoscopic extraperitoneal para-aortic lymphadenectomy in locally advanced cervical cancer: a prospective correlation of surgical findings with positron emission tomography/computed tomography findings. Cancer. 2010;117:1928–34.

    PubMed  Google Scholar 

  14. Dong Y, Wang X, Wang Y, Liu Y, Zhang J, Qian W, Wu S. Validity of 18FDG positron emission tomography/computed tomography for pretreatment evaluation of patients with cervical carcinoma. A retrospective pathology-matched study. Int J Gynecol Cancer. 2014;24:1642–7.

    PubMed  Google Scholar 

  15. Gouy S, Morice F, Narducci F, Uzan C, Rey A, Bentivegna E, Pautier P, Deandreis D, Querleu D, Haie-Meder C, LeBlanc E. Prospective multicenter study evaluating the survival of patients with locally advanced cervical cancer undergoing laparoscopic para-aortic lymphadenectomy before chemoradiotherapy in the era of PET. JCO. 2013;31:3026–33.

    Google Scholar 

  16. Aravena D, Pruzzo R, Barrena N, Amaral H, Torres P, McConell Y, Ramirez S. Accuracy of 18FDG PET/CT for the detection of para-aortic lymph node metastasis in patients with early bulky and locally advanced uterine cervical carcinoma. First national experience. Int J Gynecol Cancer. 2015;25(Suppl 1):16.

    PubMed  Google Scholar 

  17. Smits RM, Zusterzeel P, Bekkers R. Pretreatment retroperitoneal para-aortic lymph node staging in advanced cervical cancer. A review. Int J Gynecol Cancer. 2014;24:973–83.

    PubMed  Google Scholar 

  18. Chong G, Jeong S, Park S, Lee Y, Lee S, Hong D, Kim J, Lee Y, Cho Y. Comparison of the prognostic value of F-18-PETmetabolic parameters of primary tumors and regional lymph nodes in patients with locally advanced cervical cancer who are treated with concurrent chemoradiotherapy. PLoS One. 2015;10:e0137743.

    PubMed  PubMed Central  Google Scholar 

  19. Sala E, Micco M, Burger I, Yakar D, Kollmaier M, Goldman D, Gonen M, Park K, Abu-Rustum N, Hricak H, Vargas H. Complementary prognostic value of pelvic MRI and whole-body FDG PET/CT in the pretreatment assessment of patients with cervical cancer. Int J Gynecol Cancer. 2015;25:1461–7.

    PubMed  PubMed Central  Google Scholar 

  20. Frumovitz M, Querleu D, Gil-Moreno A, Morice P, Jhingran A, Munsell M, Macapinlac H, LeBlanc E, Martinez A, Ramirez P. Lymphadenectomy in Locally Advanced Cervical Cancer Study (LiLACS): a phase III clinical trial comparing surgical to radiologic staging in patients with stages IB2-IVAcervical cancer. J Minim Invasive Gynecol. 2014;21:3–8.

    PubMed  Google Scholar 

  21. Fastrez M, Goffin F, Vergote I, et al. Multi-center experience of robot-assisted laparoscopic para-aortic lymphadenectomy for staging of locally advanced cervical carcinoma. Acta Obstet Gynecol Scand. 2013;92:895–901.

    PubMed  Google Scholar 

  22. Marnitz S, Kohler C, Roth C, et al. Is there a benefit of pretreatment laparoscopic transperitoneal surgical staging in patients with advanced cervical cancer? Gynecol Oncol. 2005;99:536–44.

    PubMed  Google Scholar 

  23. Fagotti A, Fanfani F, Longo R, et al. Which role for pre-treatment laparoscopic staging? Gynecol Oncol. 2007;107:S101–5.

    PubMed  Google Scholar 

  24. Fine BA, Hempling RE, Piver MS, Baker TR, McAuley M, Driscoll D. Severe radiation morbidity in carcinoma of the cervix: impact of pretherapy surgical staging and previous surgery. Int J Radiat Oncol Biol Phys. 1995;31:717–23.

    CAS  PubMed  Google Scholar 

  25. Gouy S, Morice P, Narducci F, Uzan C, Gimore J, Kolesnikov-Gauthier H, Querleu D, Haie-Meder C, Leblanc E. Nodal staging surgery for locally advanced cervical cancer in the era of PET. Lancet Oncol. 2012;13:e212–20.

    PubMed  Google Scholar 

  26. Haie C, Pejovic MH, Gerbaulet A, Horiot JC, Pourquier H, Delouche J, Heinz JF, Brune D, Fenton J, Pizzi G, Bey P, Brossel R, Pillement P, Volterrani F, Chassagne D. Is prophylactic para-aortic irradiation worthwhile in the treatment of advanced cervical carcinoma? Results of a controlled clinical trial of the EORTC radiotherapy group. Radiother Oncol. 1988;11:101–12.

    CAS  PubMed  Google Scholar 

  27. Ghezzi F, Cromi A, Serati M, Uccella S, Formenti G, Bogani G, Vanoli P. Radiation-induced bowel complications: laparoscopic versus open staging of gynecologic malignancy. Ann Surg Oncol. 2011;18:782–91.

    PubMed  Google Scholar 

  28. Martinez A, Querleu D, LeBlanc E, Narducci F, Ferron G. Low incidence of port-site metastases after laparoscopic staging of uterine cancer. Gynecol Oncol. 2010;118:145–50.

    CAS  PubMed  Google Scholar 

  29. Park JY, Lim MC, Lim SY, Bae JM, Yoo CW, Seo SS, Kang S, Park SY. Port-side and liver metastases after laparoscopic pelvic and para-aortic lymph node dissection for surgical staging of locally advanced cervical cancer. Int J Gynecol Cancer. 2008;18:176–80.

    PubMed  Google Scholar 

  30. Gouy S, Morice P, Narducci F, et al. Prospective multicenter study evaluating the survival of patients with locally advanced cervical cancer undergoing laparoscopic para-aortic lymphadenectomy before chemoradiotherapy in the era of positron emission tomography imaging. J Clin Oncol. 2013;31:3026–33.

    PubMed  Google Scholar 

  31. Gil-Moreno A, Franco-Camps S, Cabrera S, et al. Pretherapeutic extraperitoneal laparoscopic staging of bulky or locally advanced cervical cancer. Ann Surg Oncol. 2011;18:482–9.

    PubMed  Google Scholar 

  32. Del Pino M, Fuste P, Pahisa J, et al. Laparoscopic lymphadenectomy in advanced cervical cancer: prognostic and therapeutic value. Int J Gynecol Cancer. 2013;23:1675–83.

    PubMed  Google Scholar 

  33. Diaz-Feijoo B, Gil-Ibanez B, Perez-Benavente A, et al. Comparison of robotic-assisted vs conventional laparoscopy for extraperitoneal paraaortic lymphadenectomy. Gynecol Oncol. 2014;132:98–101.

    CAS  PubMed  Google Scholar 

  34. Hasenburg A, Salama JK, Van TJ, et al. Evaluation of patients after extraperitoneal lymph node dissection and subsequent radiotherapy for cervical cancer. Gynecol Oncol. 2002;84:321–6.

    PubMed  Google Scholar 

  35. Denschlag D, Gabriel B, Mueller-Lantzsch C, et al. Evaluation of patients after extraperitoneal lymph node dissection for cervical cancer. Gynecol Oncol. 2005;96:658–64.

    CAS  PubMed  Google Scholar 

  36. Vandeperre A, Van Limbergen E, Leunen K, Moerman P, Amant F, Vergote I. Para-aortic lymph node metastases in locally advanced cervical cancer: comparison between surgical staging and imaging. Gynecol Oncol. 2015;138:299–303.

    PubMed  Google Scholar 

  37. Köhler C, Mustea A, Marnitz S, Schneider A, Chiantera V, Ulrich U, Scharf JP, Martus P, Vieira MA, Tsunoda A. Perioperative morbidity and rate of upstaging after laparoscopic staging for patients with locally advanced cervical cancer: results of a prospective randomized trial. Am J Obstet Gynecol. 2015;213:503.e1–7.

    PubMed  Google Scholar 

  38. Marnitz S, Martus P, Köhler C, Stromberger C, Asse E, Mallmann P, Schmidberger H, Junior R, Nunes J, Sehouli J, Budach V. Role of surgical versus clinical staging in chemoradiated FIGO stage IIB-IVA cervical cancer patients—acute toxicity and treatment quality of the Uterus 11 multicenter phase III intergroup trial of the German Radiation Oncology Group and the Gynecologic Cancer Group. Int J Radiat Oncol Biol Phys. 2016;94:243–53.

    PubMed  Google Scholar 

  39. Ghadjar P, Budach V, Köhler C, Jantke A, Marnitz S. Modern radiation therapy and potential fertility preservation strategies in patients with cervical cancer undergoing chemoradiation. Radiat Oncol. 2015;10:50.

    PubMed  PubMed Central  Google Scholar 

  40. Hertel H, Köhler C, Elhawary T, Michels W, Possover M, Schneider A. Laparoscopic staging compared with imaging techniques in the staging of advanced cervical cancer. Gynecol Oncol. 2002;87:46–51.

    PubMed  Google Scholar 

  41. Del Pinto M, Fuste P, Pahisa J, Rovirosa A, Martinez-Serrano MJ, Martinez-Roman S, Alonso I, Vidal L, Ordi J, Torne A. Laparoscopic lymphadenectomy in advanced cervical cancer. Prognostic and therapeutic value. Int J Gynecol Cancer. 2013;23:1675–83.

    Google Scholar 

  42. Chung HH, Lee S, Sim JK, Kim JY, Seo SS, Park SY, Roh JW. Pretreatment laparoscopic surgical staging in locally advanced cervical cancer: preliminary results in Korea. Gynecol Oncol. 2005;97:468–75.

    PubMed  Google Scholar 

  43. Lai CH, Huang KG, Hong JH, Lee CL, Chou HH, Chang TC, Hsueh S, Hang HJ, Ng KK, Tsai CS. Randomized trial of surgical staging (extraperitoneal or laparoscopic) versus clinical staging in locally advanced cervical cancer. Gynecol Oncol. 2003;89:160–7.

    PubMed  Google Scholar 

  44. Michel G, Morice P, Castaigne D, Leblanc M, Rey A, Duvillard P. Lymphatic spread in stage IB and II cervical carcinoma. Anatomy and surgical implications. Obstet Gynecol. 1998;91:360–3.

    CAS  PubMed  Google Scholar 

  45. Odunsi KO, Lele S, Ghamande S, Seago P, Driscoll DL. The impact of pre-therapy extraperitoneal surgical staging on the evaluation and treatment of patients with locally advanced cervical cancer. Eur J Gynecol Oncol. 2001;22:325–30.

    CAS  Google Scholar 

  46. Querleu D, Dargent D, Ansquer Y, LeBlanc E, Narducci F. Extraperitoneal endosurgical aortic and common iliac dissection in the staging of bulky or advanced cervical carcinomas. Cancer. 2000;88:1883–91.

    CAS  PubMed  Google Scholar 

  47. Recio FO, Piver MS, Hempling RE. Pretreatment transperitoneal laparoscopic staging pelvic and paraaortic lymphadenectomy in large (≥5cm) stage IB2 cervical carcinoma: report of a pilot study. Gynecol Oncol. 1996;63:333–6.

    CAS  PubMed  Google Scholar 

  48. Tillmanns T, Lowe MP. Safety, feasibility and costs of outpatient laparoscopic extraperitoneal aortic nodal dissection for locally advanced cervical carcinoma. Gynecol Oncol. 2007;106:370–4.

    PubMed  Google Scholar 

  49. Weiser EB, Bundy BN, Hoskins WJ, Heller PB, Whittington RR, DiSaia PJ, Curry SL, Schlaerth J, Thipgen JT. Extraperitoneal versus transperitoneal selective paraaortic lymphadenectomy in the pretreatment surgical staging of advanced cervical carcinoma (a GOG study). Gynecol Oncol. 1989;33:283–9.

    CAS  PubMed  Google Scholar 

  50. Zanvettor PH, Filho DF, Neves AR, Amorim M, Medeiros SM, Laranjeiras L, Morais JA, Araujo IO, Barbosa HS. Laparoscopic surgical staging of locally advanced cervix cancer (IB2 to IVA): initial experience. Gynecol Oncol. 2011;120:358–61.

    PubMed  Google Scholar 

  51. Holcomb K, Abulafia O, Matthews RP, Gabbur N, Lee YC, Buhl A. The impact of pretreatment staging laparotomy on survival in locally advanced cervical carcinoma. Eur J Gynaecol Oncol. 1999;20:90–3.

    CAS  PubMed  Google Scholar 

  52. LaPolla JP, Schlaerth JB, Gaddis O, Morrow CP. The influence of surgical staging on the evaluation and treatment of patients with cervical carcinoma. Gynecol Oncol. 1986;24:194–206.

    CAS  PubMed  Google Scholar 

  53. Leblanc E, Narducci F, Frumovitz M, Lesoin A, Castelein B, Baranzelli MC, Taieb S, Fournier C, Querleu D. Therapeutic value of pretherapeutic extraperitoneal laparoscopic staging of locally advanced cervical carcinoma. Gynecol Oncol. 2007;111:304–11.

    Google Scholar 

  54. Margulies AL, Peres A, Barranger E, Perreti I, Brouland JF, Toubet E, Sarda-Mantel LE, Thoury A, Chis C, Walker F, Luton D, Delpech Y, Koskas M. Selection of patients with advanced-stage cervical cancer for para-aortic lymphadenectomy in the era of PET/CT. Anticancer Res. 2013;33:283–6.

    PubMed  Google Scholar 

  55. Mortier DG, Stroobants S, Amant F, Neven P, van Limbergen E, Vergote I. Laparoscopic para-aortic lymphadenectomy and positron emission tomography scan as staging procedures in patients with cervical carcinoma stage IB2-IIIB. Int J Gynecol Cancer. 2008;18:723–9.

    CAS  PubMed  Google Scholar 

  56. Vidauretta J, Bermudez A, di Paola G, Sardi J. Laparoscopic staging in locally advanced cervical carcinoma: a new possible philosophy. Gynecol Oncol. 1999;75:366–71.

    Google Scholar 

  57. Chu KK, Chang SD, Chen FP, Soong YK. Laparoscopic surgical staging in cervical cancer—preliminary experience among Chinese. Gynecol Oncol. 1997;64:49–53.

    CAS  PubMed  Google Scholar 

  58. Heller PB, Malfetano JH, Bundy BN, Barnhill DR, Okagaki T. Clinical-pathologic study of stage IIB, III, and IVA carcinoma of the cervix: extended diagnostic evaluation for paraaortic node metastasis—a Gynecologic Oncology Group study. Gynecol Oncol. 1990;38:425–30.

    CAS  PubMed  Google Scholar 

  59. Benedetti-Panici P, Perniola G, Tomao F, Fischetti M, Savone D, Di Donato V, Angioli R, Muzii L. Un update of laparoscopy in cervical cancer staging: is it a useful procedure? Oncology. 2013;85:160–5.

    PubMed  Google Scholar 

  60. Kasamutsa T, Onda T, Sasajima Y, Kato T, Ikeda S, Ishikawa M, Tsuda H. Prognostic significance of positive peritoneal cytology in adenocarcinoma of the uterine cervix. Gynecol Oncol. 2009;115:488–92.

    Google Scholar 

  61. Benedetti-Panici P, Bellati F, Manci N, Pernice M, Plotti F, DiDonato V, Calcagno M, Zullo MA, Muzii L, Angioli R. Neoadjuvant chemotherapy followed by radical surgery in patients affected by FIGO stage IVA cervical cancer. Ann Surg Oncol. 2007;14:2643–8.

    PubMed  Google Scholar 

  62. Tsunoda A, Marnitz S, Andrade C, Neto C, Blohmer J, Herrmann J, Kerr L, Nunes J, Martus P, Schneider A, Favero G, Köhler C. Incidence of histologic proven pelvic and para-aortic lymph node metastases and rate of upstaging in patients with locally advanced cervical cancer—results of a prospective randomised trial. Gynecol Oncol, submitted.

    Google Scholar 

  63. Asiri MA, Tunio MA, Mohamed R, Bayoumi Y, Alhadab A, Saleh RM, AlArifi MS, Alobaid A. Is extended-field concurrent chemoradiation an option for radiologic negative paraaortic lymph node, locally advanced cervical cancer? Cancer Manag Res. 2014;6:339–48.

    PubMed  PubMed Central  Google Scholar 

  64. Yap ML, Cuartero J, Yan J, Pintilie M, Fyles A, Levin W, Manchul L, Milosevic M. The role of elective para-aortic lymph node irradiation in patients with locally advanced cervical cancer. Clin Oncol (R Coll Radiol). 2014;26:797–803.

    CAS  PubMed  Google Scholar 

  65. Park SG, Kim JH, Oh YK, Byun SJ, Kim MY, Kwon SH, Kim OB. Is prophylactic irradiation to para-aortic lymph nodes in locally advanced cervical cancer necessary? Cancer Res Treat. 2014;46:374–82.

    CAS  PubMed  PubMed Central  Google Scholar 

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  1. Department of Advanced Operative and Oncologic Gynecology, Asklepios Hospital, Hamburg, Germany

    Christhardt Köhler M.D. & Giovanni Favero M.D.

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Correspondence to Christhardt Köhler M.D. .

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    Geraldo Gastal Gomes-da-Silveira

  2. UFCSPA, Porto Alegre, Rio Grande do Sul, Brazil

    Gustavo Py Gomes da Silveira

  3. Universidade Federal do Rio Grande do Sul (UFRGS) and Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil

    Suzana Arenhart Pessini

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Köhler, C., Favero, G. (2018). Laparoscopic Operative Staging in Cervical Cancer. In: Gomes-da-Silveira, G.G., da Silveira, G.P.G., Pessini, S.A. (eds) Minimally Invasive Gynecology. Springer, Cham. https://doi.org/10.1007/978-3-319-72592-5_21

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