Surgical treatment of lymph node metastases in stage IB cervical cancer. the laterally extended parametrectomy (LEP) procedure: Experience with a 5 year follow-up

L. Ungár, L. Pálfalvi, László Tarnai, Dániel Horányi, Zoltán Novák

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Introduction: In 2003, we published our preliminary experience with the use of an operative technique (laterally extended parametrectomy, the LEP procedure) without adjuvant therapy, in the treatment of 29 stage IB, cervical cancer patients with pelvic lymph node metastases. In our present paper, by an extended recruiting period, with a completed 5 year follow up, we studied the outcome of LEP operations, used with the same indications. Methods: In 70 out of 106 LEP-Wertheim operated patients, no adjuvant treatment was used. In 36 patients, where histology suggested tumor spread beyond the threshold of our surgery, adjuvant chemo-radiotherapy was advised. 5 year follow up was completed (without any patient lost for follow up) for the whole cohort of patients. Results: In 70 patients treated by LEP procedure alone, the overall 5-year survival was 91.4%. For those 36 patients, who were excluded due to disease spread above study criteria, 5 year survival was 44%. Complications in 10% of the cases necessitated a second operation. Apart from transient hyper continence and one case of permanent incontinence, no severe quality of life consequence of the operation was observed. Conclusions: Our results suggest that in two-thirds of pelvic lymph node positive, stage IB cervical cancer cases surgery alone could provide equal or better survival (without the toxicity of chemo-radiotherapy), than any kind of multimodality treatment alternatives. LEP procedure should be considered a treatment option for stage IB cervical cancer patients with pelvic lymph node metastases.

Original languageEnglish
Pages (from-to)337-341
Number of pages5
JournalGynecologic Oncology
Volume123
Issue number2
DOIs
Publication statusPublished - Nov 2011

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Uterine Cervical Neoplasms
Lymph Nodes
Neoplasm Metastasis
Therapeutics
Survival
Adjuvant Radiotherapy
Histology
Radiotherapy
Quality of Life
Neoplasms

Keywords

  • Cervical cancer
  • Laterally extended parametrectomy
  • Lymph node metastasis

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology

Cite this

Surgical treatment of lymph node metastases in stage IB cervical cancer. the laterally extended parametrectomy (LEP) procedure : Experience with a 5 year follow-up. / Ungár, L.; Pálfalvi, L.; Tarnai, László; Horányi, Dániel; Novák, Zoltán.

In: Gynecologic Oncology, Vol. 123, No. 2, 11.2011, p. 337-341.

Research output: Contribution to journalArticle

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abstract = "Introduction: In 2003, we published our preliminary experience with the use of an operative technique (laterally extended parametrectomy, the LEP procedure) without adjuvant therapy, in the treatment of 29 stage IB, cervical cancer patients with pelvic lymph node metastases. In our present paper, by an extended recruiting period, with a completed 5 year follow up, we studied the outcome of LEP operations, used with the same indications. Methods: In 70 out of 106 LEP-Wertheim operated patients, no adjuvant treatment was used. In 36 patients, where histology suggested tumor spread beyond the threshold of our surgery, adjuvant chemo-radiotherapy was advised. 5 year follow up was completed (without any patient lost for follow up) for the whole cohort of patients. Results: In 70 patients treated by LEP procedure alone, the overall 5-year survival was 91.4{\%}. For those 36 patients, who were excluded due to disease spread above study criteria, 5 year survival was 44{\%}. Complications in 10{\%} of the cases necessitated a second operation. Apart from transient hyper continence and one case of permanent incontinence, no severe quality of life consequence of the operation was observed. Conclusions: Our results suggest that in two-thirds of pelvic lymph node positive, stage IB cervical cancer cases surgery alone could provide equal or better survival (without the toxicity of chemo-radiotherapy), than any kind of multimodality treatment alternatives. LEP procedure should be considered a treatment option for stage IB cervical cancer patients with pelvic lymph node metastases.",
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