An update of laparoscopy in cervical cancer staging: is it a useful procedure?

Oncology. 2013;85(3):160-5. doi: 10.1159/000351995. Epub 2013 Aug 29.

Abstract

Objective: It was the aim of this study to report on the role of laparoscopic staging in a large series of locally advanced cervical cancer (LACC) patients and its impact on prognosis.

Methods: Consecutive patients with LACC were considered for surgical staging: gynecological examination, cystoscopy and laparoscopy with peritoneal biopsies and peritoneal fluid cytology.

Results: Between February 2000 and September 2010, a total of 167 women were evaluated. In 5 patients, laparoscopy could not be performed. One hundred and sixty-two patients had correct laparoscopic staging: 49 International Federation of Gynecology and Obstetrics (FIGO) stage IB-IIA (>4 cm), 67 IIB, 39 III, and 7 IVA. Abdominal spread was found in 33 cases (20%). There was a minor laparoscopy complication rate of 1%. We found a significant difference in the distribution of peritoneal spread for tumor grade and FIGO stage (p = 0.01 and p < 0.0001, respectively), whereas no statistically significant difference for the histological type was found [p = not significant (NS)]. The median follow-up was 80 months (range 4-144). The median overall survival was 65 months. The patients without abdominal spread did not benefit from a significantly longer survival (median overall survival of 59 vs. 70 months; p = NS).

Conclusions: Laparoscopic staging in cervical cancer is a safe and feasible technique but it does not modify the prognosis of LACC patients.

MeSH terms

  • Adult
  • Aged
  • Cost-Benefit Analysis
  • Feasibility Studies
  • Female
  • Humans
  • Italy / epidemiology
  • Laparoscopy* / economics
  • Laparoscopy* / methods
  • Lymph Nodes / pathology*
  • Middle Aged
  • Neoplasm Staging
  • Peritoneum / pathology*
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Survival Rate
  • Treatment Outcome
  • Uterine Cervical Neoplasms / mortality
  • Uterine Cervical Neoplasms / pathology*