0aade74fe80ab42eca4a2c0f2f1a56bc pmc_9025856.pdf aed56592d679aff8de6a6cffe41bbae2a32d57d8 pmc_9025856.pdf 120d75d8bc3d6154b1177eb8a548508ba760c83671a55250dc2c0c712434e89d pmc_9025856.pdf Title: Surgical Outcomes of Laparoscopic Pelvic Lymph Node Debulking during Staging Aortic Lymphadenectomy in Locally Advanced Cervical Cancer: A Multicenter Study Subject: Background: Few studies have evaluated laparoscopic pelvic lymph node (PLN) debulking during staging aortic lymphadenectomy in locally advanced cervical cancer (LACC). It allows us to know the lymph node status and facilitates the action of chemoradiotherapy (CRT) by reducing tumor burden. We evaluated its feasibility and compared the perioperative morbidity and the time to CRT with a control group. Methods: This was a multicenter retrospective study of patients with LACC FIGO stage IIIC1r who were recipients of CRT. We compared two cohorts: group 1, which consisted of 164 patients with surgical staging by laparoscopic aortic lymphadenectomy and PLN debulking, and group 2, which consisted of 111 patients with aortic lymphadenectomy alone. Results: Excision of the bulky nodes was possible in all patients in group 1 except for one. Surgery lasted a median of 82 min longer in group 1 but there was no greater intraoperative bleeding or increased hospital stay. There were no significant differences in intraoperative or postoperative complications between the groups. A significantly shorter time from surgery to the start of RT was observed in group 1. Conclusions: It is feasible to perform laparoscopic PLN debulking in the same procedure as the staging aortic lymphadenectomy in LACC without increasing surgical or postoperative complications and without delaying the start of CRT compared to single aortic lymphadenectomy. Keywords: aortic lymphadenectomy; locally advanced cervical cancer; pelvic lymph node debulking; surgical staging Author: Berta Díaz-Feijoó, Úrsula Acosta, Aureli Torné, Blanca Gil-Ibáñez, Alicia Hernández, Santiago Domingo, Melissa Bradbury and Antonio Gil-Moreno Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Thu Apr 14 10:18:56 2022 CEST ModDate: Thu Apr 14 10:23:55 2022 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 15 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 618136 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- DVHPBD+VnURWPalladioL Type 1 Custom yes yes no 10 0 FHXOSJ+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 PXOBVI+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 MTUGBO+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 HNMBQN+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 36 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 40 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 44 0 LCJEVJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 57 0 TNBSFT+CMSY10 Type 1 Builtin yes yes no 82 0 OVNEXW+EURM10 Type 1 Builtin yes yes no 89 0 BCDEEE+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 101 0 BCDFEE+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 105 0 BCDGEE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 109 0 BCDHEE+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 113 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 124 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-04-03 02:43:20 CEST RepresentationInformation: pmc_9025856.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2023-10-07 02:17:28 CEST Size: 618136 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 312 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Design and Participants Destination: subsection.2.1 Item: Title: Staging of Lymph Node Involvement by Imaging Test Destination: subsection.2.2 Item: Title: Surgical Staging Procedure Destination: subsection.2.3 Item: Title: Complications Destination: subsection.2.4 Item: Title: Chemoradiation Treatment Destination: subsection.2.5 Item: Title: Statistical Analysis Destination: subsection.2.6 Item: Title: Results Destination: section.3 Children: Item: Title: Surgical Staging Destination: subsection.3.1 Item: Title: Surgery-Related Complications Destination: subsection.3.2 Item: Title: Discussion Destination: section.4 Children: Item: Title: Surgical Technique Destination: subsection.4.1 Item: Title: Surgical Morbidity Destination: subsection.4.2 Item: Title: Delay in CRT Treatment Destination: subsection.4.3 Item: Title: Strengths and Limitations Destination: subsection.4.4 Item: Title: Implications for Practice and Future Research Destination: subsection.4.5 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: Surgical Outcomes of Laparoscopic Pelvic Lymph Node Debulking during Staging Aortic Lymphadenectomy in Locally Advanced Cervical Cancer: A Multicenter Study Author: Berta Díaz-Feijoó, Úrsula Acosta, Aureli Torné, Blanca Gil-Ibáñez, Alicia Hernández, Santiago Domingo, Melissa Bradbury and Antonio Gil-Moreno Subject: Background: Few studies have evaluated laparoscopic pelvic lymph node (PLN) debulking during staging aortic lymphadenectomy in locally advanced cervical cancer (LACC). It allows us to know the lymph node status and facilitates the action of chemoradiotherapy (CRT) by reducing tumor burden. We evaluated its feasibility and compared the perioperative morbidity and the time to CRT with a control group. Methods: This was a multicenter retrospective study of patients with LACC FIGO stage IIIC1r who were recipients of CRT. We compared two cohorts: group 1, which consisted of 164 patients with surgical staging by laparoscopic aortic lymphadenectomy and PLN debulking, and group 2, which consisted of 111 patients with aortic lymphadenectomy alone. Results: Excision of the bulky nodes was possible in all patients in group 1 except for one. Surgery lasted a median of 82 min longer in group 1 but there was no greater intraoperative bleeding or increased hospital stay. There were no significant differences in intraoperative or postoperative complications between the groups. A significantly shorter time from surgery to the start of RT was observed in group 1. Conclusions: It is feasible to perform laparoscopic PLN debulking in the same procedure as the staging aortic lymphadenectomy in LACC without increasing surgical or postoperative complications and without delaying the start of CRT compared to single aortic lymphadenectomy. 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