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.