LAPAROSCOPIC STAGING IN LOCALLY ADVANCED CERVICAL CANCER

Abstract

Approximately 528 000 new cases and 266 000 deaths per year are attributed to cervical cancer (CC) worldwide. The implementation of laparoscopic techniques minimized intraand postoperative complications and allowed precise identification the disease stage, which can be used to individualize the treatment of locally advanced CC. Objective: to determine the role of laparoscopic staging in the treatment of locally advanced CC. Materials and methods. The study included 216 patients with stage IB2–IIIB CC according to the International Federation of Gynecology and Obstetrics staging system for cervical cancer (2011). The main group included 60 patients who underwent laparoscopic staging before treatment initiation; all participants in this group received individual treatment according to the results of laparoscopic staging. Comparison groups comprised patients receiving combined treatment (n = 99) and radical chemoradiotherapy (n = 57). Results. Mean duration of surgery was 148.67 ± 66.57 min; mean number of lymph nodes removed was 12.83 ± 6.43. After laparoscopic evaluation, the stage of the tumor was corrected in 34 (56.67 %) patients: in 23 cases (38.33 %) the tumor was preoperatively underestimated, in 11 cases (18.33 %) it was overestimated. The diagnostic accuracy of assessing the status of regional lymph nodes using magnetic resonance imaging and ultrasound examination was 60.19 % and 63.16 % respectively. Conclusion. Laparoscopic staging is an effective and safe method to determine the stage and the extent of the tumor, which allows individualizing the treatment of locally advanced CC.