Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2007
Stage-adjusted chemoradiation in cervical cancer after transperitoneal laparoscopic staging.
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Marnitz Simone, Köhler Christhardt, Roth Christina, Füller Jürgen, Bischoff Annett, Wendt Thomas, Schneider Achim, Budach Volker
Аннотация
PURPOSE: To evaluate the impact of transperitoneal laparoscopic staging on choice of subsequent therapy including oncologic outcome and toxicity of chemoradiation after surgical staging.
PATIENTS AND METHODS: 101 patients with cervical cancer FIGO IB1-IVB underwent chemoradiation after transperitoneal laparoscopic staging.
RESULTS: 101 women (FIGO IB1-IVB) were laparoscopically staged. In 68/101 patients, pelvic and/or paraaortic lymph node metastases were confirmed histologically. Only 17/101 patients (17%) retained their original FIGO stage after laparoscopy. Laparoscopic staging and chemoradiation were well tolerated. Laparoscopic debulking of tumor-involved lymph nodes resulted in significantly improved overall survival.
CONCLUSION: In patients with cervical cancer, laparoscopic staging led to an upstaging of 83% of cases with significant impact on therapeutic strategies. Nodal debulking prior to chemoradiation improves the prognosis of node positive women. Pretherapeutic laparoscopic staging should be the basis of the primary chemoradiation in patients with cervical cancer.
PATIENTS AND METHODS: 101 patients with cervical cancer FIGO IB1-IVB underwent chemoradiation after transperitoneal laparoscopic staging.
RESULTS: 101 women (FIGO IB1-IVB) were laparoscopically staged. In 68/101 patients, pelvic and/or paraaortic lymph node metastases were confirmed histologically. Only 17/101 patients (17%) retained their original FIGO stage after laparoscopy. Laparoscopic staging and chemoradiation were well tolerated. Laparoscopic debulking of tumor-involved lymph nodes resulted in significantly improved overall survival.
CONCLUSION: In patients with cervical cancer, laparoscopic staging led to an upstaging of 83% of cases with significant impact on therapeutic strategies. Nodal debulking prior to chemoradiation improves the prognosis of node positive women. Pretherapeutic laparoscopic staging should be the basis of the primary chemoradiation in patients with cervical cancer.
Предметные рубрики MeSH
AdenocarcinomaAntineoplastic Combined Chemotherapy ProtocolsBrachytherapyCarboplatinCarcinoma, AdenosquamousCarcinoma, Squamous CellCisplatinCombined Modality TherapyDrug Administration ScheduleFemaleFluorouracilFollow-Up StudiesHumansLaparoscopyLymph Node ExcisionLymphatic MetastasisNeoplasm InvasivenessNeoplasm StagingRadiotherapy DosageRectumSurvival RateUrinary BladderUterine Cervical Neoplasms