Abstract
Backgroud: Extended-field concurrent chemoradiation therapy (Ex-CCRT) is widely used for para-aortic lymph node (PAN) metastasis confirmed by radiographic assessment without surgical assessment. 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 metastases.Methods: From May 2017 to March 2020, patients with stage IIB-IIIB cervical cancer, who were diagnosed with pelvic node metastasis using positron emission tomography-computed tomography (PET-CT) with SUVmax ≥ 2.0, underwent laparoscopic retroperitoneal PAN biopsy. The radiation fields were extended to the PAN area with pathological metastases.Results: Fourteen patients were diagnosed with squamous cell carcinoma of the cervix at FIGO stage IIB (n=7) and IIIB (n=7). The median operating time was 138 (range, 104–184) minutes. The median number of harvested PANs was 19 (range, 6–36). Three patients were diagnosed as positive for PAN metastasis by histological analysis. In this study, the sensitivity and specificity of PET-CT were 66.7% and 90.9%, respectively.Conclisions: The results of this study revealed that laparoscopic retroperitoneal PAN should be the standard treatment method worldwide because it is not appropriate to determine the radiation field of PAN by image examination without performing a histological assessment.
Laparoscopic Retroperitoneal Para-aortic Lymph Node Biopsy in Advanced Cervical Cancer with Pelvic Lymph Node Metastases: A Single-centre Prospective Study
