SP-0743: For the motion rebuttal: Para-aortic lymph node sampling should always be performed in case of pelvic N + disease

A 40-year-old woman with mucoepidermoid variant of adenosquamous carcinoma arising in dermoid cyst in left ovary is presented. The patient was staged as IC. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and pelvic and para-aortic lymph node sampling were carried out. The disease recurred in postoperative 12th month. To our best knowledge, this is 12th case of adenosquamous carcinoma in dermoid cyst and third case of mucoepidermoid variant of adenosquamous carcinoma in the literature.

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Surgical and Pathological Outcomes of Laparoscopic Versus Abdominal Radical Hysterectomy With Pelvic Lymphadenectomy and/or Para-aortic Lymph Node Sampling for Bulky Early-Stage Cervical Cancer

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000716 ◽

2017 ◽

Vol 27 (6) ◽

pp. 1222-1227 ◽

Cited By ~ 6

Author(s):

Tao Zhu ◽

Xi Chen ◽

Jianqing Zhu ◽

Yaqing Chen ◽

Aijun Yu ◽

...

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Radical Hysterectomy ◽

Early Stage ◽

Pelvic Lymphadenectomy ◽

Tumor Diameter ◽

Laparoscopic Radical Hysterectomy ◽

Lymph Node Sampling ◽

Aortic Lymph Node ◽

Early Stage Cervical Cancer

Background and ObjectivesThe aim of this study was to compare the feasibility, morbidity, and recurrence rate of total laparoscopic radical hysterectomy (LRH) with those of abdominal radical hysterectomy (ARH) for bulky early-stage cervical cancer.MethodsWe performed a retrospective cohort study of 112 patients with stage IB1 or IIA2 cervical cancer in which the tumor diameter was 3 cm or greater. All patients underwent LRH (n = 30) or ARH (n = 82) with pelvic lymphadenectomy and/or para-aortic lymph node sampling between May 2011 and November 2014. Perioperative outcomes were compared between the 2 surgical groups.ResultsThe laparoscopic approach consisted of 4 trocar insertions. Age, tumor diameter, and pelvic lymph nodes significantly differed between the 2 cohorts. Body mass index, International Federation of Gynecology and Obstetrics stage, histologic type and grade, deep stromal invasion, lymphovascular space invasion, positive margins, and adjuvant therapy were not significantly different between the 2 cohorts. Laparoscopic radical hysterectomy exhibited favorable results compared with ARH in terms of operating time, blood loss, intestinal exhaust time, and length of hospital stay. In addition, recurrence was observed in 5 LRH patients (16.7%) and 9 ARH patients (11.7%).ConclusionsThe surgical outcomes of LRH with pelvic lymphadenectomy and/or para-aortic lymph node sampling exhibited a similar therapeutic efficacy to those of the ARH approach.

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Single-Port Laparoscopic Pelvic and Para-Aortic Lymph Node Sampling or Lymphadenectomy

International Journal of Gynecological Cancer ◽

10.1111/igc.0b013e3181ea7f5d ◽

2010 ◽

Vol 20 (7) ◽

pp. 1268-1273 ◽

Cited By ~ 51

Author(s):

Pedro F. Escobar ◽

Amanda Nickles Fader ◽

Nabila Rasool ◽

Luis Rojas Espalliat

Keyword(s):

Lymph Node ◽

Single Port ◽

Lymph Node Sampling ◽

Aortic Lymph Node

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Role of para-aortic lymph node sampling in pancreatic cancer surgery.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.4_suppl.715 ◽

2020 ◽

Vol 38 (4_suppl) ◽

pp. 715-715

Author(s):

Yusuke Kazami ◽

Hiromichi Ito ◽

Yoshihiro Ono ◽

Takafumi Sato ◽

Yosuke Inoue ◽

...

Keyword(s):

Pancreatic Cancer ◽

Lymph Node ◽

Pancreatic Resection ◽

Pancreatic Head ◽

Imaging Study ◽

Resectable Pancreatic Cancer ◽

Lymph Node Sampling ◽

Aortic Lymph Node

715 Background: In the management of pancreatic cancer, para-aortic lymph node (PALN) metastasis is regarded as distant metastasis, and systemic treatment is recommended. However, imaging study is not perfect to detect all PALN metastasis and the management of intraoperatively discovered PALN has been controversial. We hypothesized that sampling of PALNs on exploration could allow us to avoid pancreatic resection for patients who would not benefit. In this study, we evaluated the incidence and the effect on the long-term outcomes for patients with potentially resectable pancreatic cancer. Methods: Three hundred and ninety-two patients who had PALNs sampled upon potentially resectable pancreatic cancer from 2005 through 2014 were included in the study. All patients were appropriately staged preoperatively with CT/MRI and those with suspected PALN metastasis were not considered as candidates for resection. The patients whose resections were aborted because of liver metastasis or peritoneal dissemination discovered on exploration, or those who died within 30-days after the operation were not included. Evaluated outcomes were incidence of PALN metastasis and their recurrence-free and overall survivals (RFS, OS). Results: The patients’ median age was 74 years, and 58.6% was man. 67.8% had tumors at pancreatic head. Preoperative chemotherapy was given only on 16 patients (3.2%). Among 392 patients with PALNs sampled, 53 (13.5%) patients had metastasis; Resection was completed on 40 patients and resection was aborted on the rest. Among patients who underwent pancreatic resection, median RFS and OS were 10 and 12 months for patients with PALN metastasis, compared to 17 and 26 months for those without PALN metastasis (p < 0.001 for RFS and p < 0.001 for OS). The 5-year-OS rates for patients with/without PALN metastasis were 5.9% and 25% (p < 0.001). Among 53 patients with PALN metastasis, OS were not different between the patients who underwent resection and those who did not (median 13 months vs 17 months, p = 0.06), and there were no recurrence-free survivors. Conclusions: PALN sampling and evaluation before committing to resection is useful to identify the patients who can unlikely benefit and to avoid unnecessary morbid operation.

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