TY - JOUR
T1 - Laparoscopic Radical Hysterectomy After Concomitant Chemoradiation in Locally Advanced Cervical Cancer: A Prospective Phase II Study
AU - Gallotta, Valerio
AU - Ferrandina, Maria Gabriella
AU - Chiantera, Vito
AU - Fagotti, Anna
AU - Fanfani, Francesco
AU - Ercoli, Alfredo
AU - Legge, Francesco
AU - Costantini, Barbara
AU - Alletti, Salvatore Gueli
AU - Bottoni, Carolina
AU - Anchora, Luigi Pedone
AU - Nero, Camilla
AU - Scambia, Giovanni
PY - 2015
Y1 - 2015
N2 - OBJECTIVE:
To assess the feasibility of laparoscopic radical surgery in patients with locally advanced cervical cancer (LACC) who receive chemoradiation therapy (CT/RT).
DESIGN:
Prospective phase II study (Canadian Task Force classification II-1).
INTERVENTION:
Patients with LACC (FIGO stage IB2-III) were evaluated for accrual at the Gynecologic Oncology Unit of Catholic University, Rome/Campobasso. Neoadjuvant CT/RT included whole-pelvic irradiation (total dose, 45.0-50.4 Gy) combined with cisplatin and 5-fluorouracil. Objective response to treatment was evaluated according to Response Evaluation Criteria in Solid Tumors criteria. Laparoscopic radical hysterectomy (RH) plus pelvic and/or aortic lymphadenectomy was attempted within 6 to 8 weeks after CT/RT. The feasibility of laparoscopic RH, as well as the rate, pattern, and severity of early and late postoperative complications, were analyzed.
RESULTS:
Between January 2010 and October 2013, a total of 58 patients were enrolled into the study. After CT/RT, 23 patients (39.6%) underwent type B2 RH, 31 (53.4%) underwent type C1 RH, and 4 (6.9%) underwent type C2 RH. Pelvic lymphadenectomy was performed in all cases. Laparoscopic RH was feasible in 55 of 58 cases (feasibility rate, 94.8%). No intraoperative complications were recorded. During the observation period (median, 22 months; range, 5-50 months), there were 28 complications, of which only 21.4% were grade 2 complications and 14.3% were grade 3 complications. As of January 2015, disease recurrence was documented in 4 cases (6.9%).
CONCLUSION:
Total laparoscopic radical surgery is feasible in patients with LACC receiving preoperative CT/RT, providing perioperative outcomes comparable to those registered in early-stage disease.
AB - OBJECTIVE:
To assess the feasibility of laparoscopic radical surgery in patients with locally advanced cervical cancer (LACC) who receive chemoradiation therapy (CT/RT).
DESIGN:
Prospective phase II study (Canadian Task Force classification II-1).
INTERVENTION:
Patients with LACC (FIGO stage IB2-III) were evaluated for accrual at the Gynecologic Oncology Unit of Catholic University, Rome/Campobasso. Neoadjuvant CT/RT included whole-pelvic irradiation (total dose, 45.0-50.4 Gy) combined with cisplatin and 5-fluorouracil. Objective response to treatment was evaluated according to Response Evaluation Criteria in Solid Tumors criteria. Laparoscopic radical hysterectomy (RH) plus pelvic and/or aortic lymphadenectomy was attempted within 6 to 8 weeks after CT/RT. The feasibility of laparoscopic RH, as well as the rate, pattern, and severity of early and late postoperative complications, were analyzed.
RESULTS:
Between January 2010 and October 2013, a total of 58 patients were enrolled into the study. After CT/RT, 23 patients (39.6%) underwent type B2 RH, 31 (53.4%) underwent type C1 RH, and 4 (6.9%) underwent type C2 RH. Pelvic lymphadenectomy was performed in all cases. Laparoscopic RH was feasible in 55 of 58 cases (feasibility rate, 94.8%). No intraoperative complications were recorded. During the observation period (median, 22 months; range, 5-50 months), there were 28 complications, of which only 21.4% were grade 2 complications and 14.3% were grade 3 complications. As of January 2015, disease recurrence was documented in 4 cases (6.9%).
CONCLUSION:
Total laparoscopic radical surgery is feasible in patients with LACC receiving preoperative CT/RT, providing perioperative outcomes comparable to those registered in early-stage disease.
KW - Laparoscopic Radical Hysterectomy
KW - cervical cancer
KW - Laparoscopic Radical Hysterectomy
KW - cervical cancer
UR - http://hdl.handle.net/10807/70211
U2 - 10.1016/j.jmig.2015.04.014
DO - 10.1016/j.jmig.2015.04.014
M3 - Article
SN - 1553-4650
VL - 22
SP - 877
EP - 883
JO - Journal of Minimally Invasive Gynecology
JF - Journal of Minimally Invasive Gynecology
ER -