The prospective study of the value of extraperitoneal pelvic lymph node dissection for patients with stage IB2-IIB cervical cancer.

ABSTRACT

Objective: To evaluate the value of extraperitoneal pelvic node dissection as a new diagnostic tool for evaluation of retroperitoneal pelvic node status in cervical cancer stage IB2-IIB patients after neoadjuvant chemotherapy. Complications of the procedure were also evaluated. Methods: Patients with cervical cancer stage IB2-IIB received neoadjuvant chemotherapy for 3 cycles. After that the patients underwent extraperitoneal pelvic node dissection and the nodes were sent for frozen section. If the frozen section was negative for metastases, radical hysterectomy was performed. If the frozen section was positive, radical hysterectomy was abandoned and the patients were treated by radiation. The value of extraperitoneal pelvic node dissection as a diagnostic tool for evaluating the extent of the disease was compared to that of transperitoneal pelvic node dissection as historical control. Results: Twenty-three patients were included in the study. Nineteen patients (83%) underwent radical hysterectomy after extraperitoneal node dissection; however, the procedure was abandoned in 3 patients (13%) due to positive frozen section of the lymph nodes. The frozen section lymph node yielded a false negative result in one patient (4%). The operative time, lymph node yield and the incidence of postoperative complications were not statistically different between extraperitoneal approach and transperitoneal approach. Conclusion: Extrapertoneal pelvic node dissection seems more suitable than transperitoneal pelvic node dissection for the evaluation of retroperitoneal pelvic node status in cervical cancer patients.