Surgical treatment of lymph node metastases in stage IB cervical cancer: the laterally extended parametrectomy (LEP) procedure

Int J Gynecol Cancer. 2003 Sep-Oct;13(5):647-51. doi: 10.1046/j.1525-1438.2003.13377.x.

Abstract

A surgical method has been introduced for the treatment of early stage cervical cancer patients with pelvic lymph node metastases. The procedure was used without any adjuvant treatment in 31 stage IB cervical cancer patients, where pelvic lymph node metastases were proven by intraoperative histology. Two patients were lost for follow-up. Twenty-nine patients were followed up for 24-105 months (mean 60 months). Twenty-five of 29 patients were alive and disease-free at the end of the study period. Kaplan-Meier 5 years cumulative proportion survival was 85% (SE 7%). Complications in four cases (16%) necessitated a second operation. One patient developed treatment-refractory grade II incontinence. All but the one incontinent patient are alive without significant treatment related symptoms. The results suggest that pelvic lymph node metastases can be cured by surgery alone. The LEP procedure seems to be a treatment alternative to chemoradiotherapy for early stage cervical cancer patients with pelvic lymph node metastases.

MeSH terms

  • Adult
  • Disease-Free Survival
  • Female
  • Humans
  • Hungary / epidemiology
  • Lymph Node Excision / methods
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery*
  • Lymphatic Metastasis / pathology
  • Medical Records
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery*
  • Neoplasm Staging
  • Pelvis
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome
  • Uterine Cervical Neoplasms / mortality
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / surgery*