Minimally invasive salvage lymphadenectomy in gynecological cancer patients: A single institution series

Valerio Gallotta*, Maria Teresa Giudice, Carmine Conte, Alicia Vazquez Sarandeses, Marco D'Indinosante, Alex Federico, Lucia Tortorella, Maria Vittoria Carbone, Salvatore Gueli Alletti, Giuseppe Vizzielli, Barbara Costantini, Giovanni Scambia, Maria Gabriella Ferrandina

*Autore corrispondente per questo lavoro

Risultato della ricerca: Contributo in rivistaArticolo in rivista

13 Citazioni (Scopus)

Abstract

BACKGROUND: to assess the feasibility of minimally invasive surgery in the management of lymph-nodal recurrences of gynecological cancers, in terms of surgical and oncological outcomes. METHODS: we retrospectively collected patients with isolated lymph-nodal recurrent disease of gynecological malignancies who underwent to minimally invasive lymphadenectomy at Catholic University of the Sacred Hearth in Rome (Italy), from January 2013 to November 2017. RESULTS: Forty patients were considered eligible (31 LPS, 9 Robot); 24 (60.0%) with an ovarian cancer, 8 (20.0%) with a cervical cancer and 8 (20.0%) with an endometrial cancer recurrence. The most frequent site of lymph-nodal recurrence was represented by the aortic region (47.5%), while 18 patients (45.0%) experiencing pelvic lymph-nodal recurrence, 2 (5.0%) both pelvic and aortic relapse, and only 1 (2.5%) had an hepato-celiac lymph node recurrence. No patient required a laparotomic conversion. Median operative time was 220 min, median EBL was 80 mL, and median post-operative hospital stay was 2 days. There were 2 (5.0%) intra-operative and 4 (10.0%) post-operative complications, of which 2 were grade 3. The median follow-up was 22.5 months, and during this time 15 patients showed another relapse with a median time to progression of 12 months. Seven women died because of the disease. The 2-year post-relapse disease-free survival (PR-DFS) was 54.7%, and the 2-year post-relapse overall survival (PR-OS) was 79.3%. CONCLUSIONS: In our experience minimally invasive surgery is a valid therapeutic approach in very select patients with localized lymph-nodal recurrence of gynecological cancers, with benefits about peri and post-operative morbidities and without compromising their oncological outcome.
Lingua originaleEnglish
pagine (da-a)31275-31277
Numero di pagine3
RivistaEuropean Journal of Surgical Oncology
DOI
Stato di pubblicazionePubblicato - 2018

Keywords

  • Innovative technologies in surgery
  • Minimally invasive lymphadenectomy
  • Personalized medicine
  • Recurrent gynecological cancers
  • Robotic surgery
  • Secondary cytoreduction

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