Total laparoscopic radical hysterectomy and pelvic lymphadenectomy in locally advanced stage IB2-IIB cervical cancer patients after neoadjuvant chemotherapy

E. Vizza, A. Pellegrino, R. Milani, R. Fruscio, E. Baiocco, F. Cognetti, A. Savarese, F. Tomao, C. Chen, G. Corrado

Research output: Contribution to journalArticle

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Abstract

Objective: To evaluate the feasibility and morbidity of total laparoscopic class C2 radical hysterectomy (TLRH) with pelvic lymphadenectomy in patients with locally advanced cervical cancer stage IB2 to IIB after neoadjuvant chemotherapy (NACT). Methods: A prospective study was conducted from October 2004 to September 2009. Cervical cancer patients, stage IB2-IIB with complete clinical response after 3 courses of NACT with paclitaxel 175 mg/m2, ifosfamide 5 g/m2 and cisplatin 75 mg/m2 (TIP) underwent TLRH. Results: Forty patients were included, with a median age of 46 years (range, 25-65), BMI of 24 kg/m2 (range, 15-49). FIGO staging was IB2 in 23, IIA > 4 cm in 6 and IIB in 11 patients. Four patients required conversion to laparotomy. Pathological evaluation showed 9 complete response (pCR), 9 partial response (pPR1) with microscopic tumour, and 15 partial response (pPR2) with macroscopic tumour. Three patients had no response. The median operative time was 305 min (range, 215-430); the median estimated blood loss was 250 ml (range, 100-400), with four postoperative blood transfusion; the median number of removed pelvic lymph nodes was 25 (range, 11-64). The median length of hospital stay was 6 days (range, 3-12). The median follow-up time was 37 months (range, 10-69), with three patients having a recurrence. One patient died of disease (DOD) after 12 months. Conclusions: TLRH can be safely performed in patients with stage IB2-IIB carcinoma of cervix after NACT, with advantages of minimal blood loss and morbidity.

Original languageEnglish
Pages (from-to)364-369
Number of pages6
JournalEuropean Journal of Surgical Oncology
Volume37
Issue number4
DOIs
Publication statusPublished - Apr 1 2011

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Lymph Node Excision
Hysterectomy
Uterine Cervical Neoplasms
Drug Therapy
Length of Stay
Morbidity
Ifosfamide
Operative Time
Paclitaxel
Cervix Uteri
Blood Transfusion
Laparotomy
Cisplatin
Neoplasms
Lymph Nodes
Prospective Studies
Carcinoma
Recurrence

Keywords

  • Cervical cancer
  • Neoadjuvant chemotherapy
  • Total laparoscopic radical hysterectomy

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Total laparoscopic radical hysterectomy and pelvic lymphadenectomy in locally advanced stage IB2-IIB cervical cancer patients after neoadjuvant chemotherapy. / Vizza, E.; Pellegrino, A.; Milani, R.; Fruscio, R.; Baiocco, E.; Cognetti, F.; Savarese, A.; Tomao, F.; Chen, C.; Corrado, G.

In: European Journal of Surgical Oncology, Vol. 37, No. 4, 01.04.2011, p. 364-369.

Research output: Contribution to journalArticle

Vizza, E. ; Pellegrino, A. ; Milani, R. ; Fruscio, R. ; Baiocco, E. ; Cognetti, F. ; Savarese, A. ; Tomao, F. ; Chen, C. ; Corrado, G. / Total laparoscopic radical hysterectomy and pelvic lymphadenectomy in locally advanced stage IB2-IIB cervical cancer patients after neoadjuvant chemotherapy. In: European Journal of Surgical Oncology. 2011 ; Vol. 37, No. 4. pp. 364-369.
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T1 - Total laparoscopic radical hysterectomy and pelvic lymphadenectomy in locally advanced stage IB2-IIB cervical cancer patients after neoadjuvant chemotherapy

AU - Vizza, E.

AU - Pellegrino, A.

AU - Milani, R.

AU - Fruscio, R.

AU - Baiocco, E.

AU - Cognetti, F.

AU - Savarese, A.

AU - Tomao, F.

AU - Chen, C.

AU - Corrado, G.

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N2 - Objective: To evaluate the feasibility and morbidity of total laparoscopic class C2 radical hysterectomy (TLRH) with pelvic lymphadenectomy in patients with locally advanced cervical cancer stage IB2 to IIB after neoadjuvant chemotherapy (NACT). Methods: A prospective study was conducted from October 2004 to September 2009. Cervical cancer patients, stage IB2-IIB with complete clinical response after 3 courses of NACT with paclitaxel 175 mg/m2, ifosfamide 5 g/m2 and cisplatin 75 mg/m2 (TIP) underwent TLRH. Results: Forty patients were included, with a median age of 46 years (range, 25-65), BMI of 24 kg/m2 (range, 15-49). FIGO staging was IB2 in 23, IIA > 4 cm in 6 and IIB in 11 patients. Four patients required conversion to laparotomy. Pathological evaluation showed 9 complete response (pCR), 9 partial response (pPR1) with microscopic tumour, and 15 partial response (pPR2) with macroscopic tumour. Three patients had no response. The median operative time was 305 min (range, 215-430); the median estimated blood loss was 250 ml (range, 100-400), with four postoperative blood transfusion; the median number of removed pelvic lymph nodes was 25 (range, 11-64). The median length of hospital stay was 6 days (range, 3-12). The median follow-up time was 37 months (range, 10-69), with three patients having a recurrence. One patient died of disease (DOD) after 12 months. Conclusions: TLRH can be safely performed in patients with stage IB2-IIB carcinoma of cervix after NACT, with advantages of minimal blood loss and morbidity.

AB - Objective: To evaluate the feasibility and morbidity of total laparoscopic class C2 radical hysterectomy (TLRH) with pelvic lymphadenectomy in patients with locally advanced cervical cancer stage IB2 to IIB after neoadjuvant chemotherapy (NACT). Methods: A prospective study was conducted from October 2004 to September 2009. Cervical cancer patients, stage IB2-IIB with complete clinical response after 3 courses of NACT with paclitaxel 175 mg/m2, ifosfamide 5 g/m2 and cisplatin 75 mg/m2 (TIP) underwent TLRH. Results: Forty patients were included, with a median age of 46 years (range, 25-65), BMI of 24 kg/m2 (range, 15-49). FIGO staging was IB2 in 23, IIA > 4 cm in 6 and IIB in 11 patients. Four patients required conversion to laparotomy. Pathological evaluation showed 9 complete response (pCR), 9 partial response (pPR1) with microscopic tumour, and 15 partial response (pPR2) with macroscopic tumour. Three patients had no response. The median operative time was 305 min (range, 215-430); the median estimated blood loss was 250 ml (range, 100-400), with four postoperative blood transfusion; the median number of removed pelvic lymph nodes was 25 (range, 11-64). The median length of hospital stay was 6 days (range, 3-12). The median follow-up time was 37 months (range, 10-69), with three patients having a recurrence. One patient died of disease (DOD) after 12 months. Conclusions: TLRH can be safely performed in patients with stage IB2-IIB carcinoma of cervix after NACT, with advantages of minimal blood loss and morbidity.

KW - Cervical cancer

KW - Neoadjuvant chemotherapy

KW - Total laparoscopic radical hysterectomy

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