Minimally invasive salvage lymphadenectomy in gynecological cancer patients: A single institution series

Valerio Gallotta, Maria Teresa Giudice, Carmine Conte, Alicia Vazquez Sarandeses, Marco D'Indinosante, Alex Federico, Lucia Tortorella, Maria Vittoria Carbone, Salvatore Gueli Alletti, Giuseppe Vizzielli, Barbara Costantini, Giovanni Scambia, Maria Gabriella Ferrandina

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: to assess the feasibility of minimally invasive surgery in the management of lymph-nodal recurrences of gynecological cancers, in terms of surgical and oncological outcomes. Methods: we retrospectively collected patients with isolated lymph-nodal recurrent disease of gynecological malignancies who underwent to minimally invasive lymphadenectomy at Catholic University of the Sacred Hearth in Rome (Italy), from January 2013 to November 2017. Results: Forty patients were considered eligible (31 LPS, 9 Robot); 24 (60.0%) with an ovarian cancer, 8 (20.0%) with a cervical cancer and 8 (20.0%) with an endometrial cancer recurrence. The most frequent site of lymph-nodal recurrence was represented by the aortic region (47.5%), while 18 patients (45.0%) experiencing pelvic lymph-nodal recurrence, 2 (5.0%) both pelvic and aortic relapse, and only 1 (2.5%) had an hepato-celiac lymph node recurrence. No patient required a laparotomic conversion. Median operative time was 220 min, median EBL was 80 mL, and median post-operative hospital stay was 2 days. There were 2 (5.0%) intra-operative and 4 (10.0%) post-operative complications, of which 2 were grade 3. The median follow-up was 22.5 months, and during this time 15 patients showed another relapse with a median time to progression of 12 months. Seven women died because of the disease. The 2-year post-relapse disease-free survival (PR-DFS) was 54.7%, and the 2-year post-relapse overall survival (PR-OS) was 79.3%. Conclusions: In our experience minimally invasive surgery is a valid therapeutic approach in very select patients with localized lymph-nodal recurrence of gynecological cancers, with benefits about peri and post-operative morbidities and without compromising their oncological outcome.

Original languageEnglish
Pages (from-to)1568-1572
Number of pages5
JournalEuropean Journal of Surgical Oncology
Volume44
Issue number10
DOIs
Publication statusPublished - Oct 1 2018

Fingerprint

Lymph Node Excision
Recurrence
Lymph
Neoplasms
Minimally Invasive Surgical Procedures
Endometrial Neoplasms
Operative Time
Uterine Cervical Neoplasms
Abdomen
Ovarian Neoplasms
Italy
Disease-Free Survival
Length of Stay
Lymph Nodes
Morbidity
Survival

Keywords

  • Innovative technologies in surgery
  • Minimally invasive lymphadenectomy
  • Personalized medicine
  • Recurrent gynecological cancers
  • Robotic surgery
  • Secondary cytoreduction

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Minimally invasive salvage lymphadenectomy in gynecological cancer patients : A single institution series. / Gallotta, Valerio; Giudice, Maria Teresa; Conte, Carmine; Sarandeses, Alicia Vazquez; D'Indinosante, Marco; Federico, Alex; Tortorella, Lucia; Carbone, Maria Vittoria; Gueli Alletti, Salvatore; Vizzielli, Giuseppe; Costantini, Barbara; Scambia, Giovanni; Ferrandina, Maria Gabriella.

In: European Journal of Surgical Oncology, Vol. 44, No. 10, 01.10.2018, p. 1568-1572.

Research output: Contribution to journalArticle

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abstract = "Background: to assess the feasibility of minimally invasive surgery in the management of lymph-nodal recurrences of gynecological cancers, in terms of surgical and oncological outcomes. Methods: we retrospectively collected patients with isolated lymph-nodal recurrent disease of gynecological malignancies who underwent to minimally invasive lymphadenectomy at Catholic University of the Sacred Hearth in Rome (Italy), from January 2013 to November 2017. Results: Forty patients were considered eligible (31 LPS, 9 Robot); 24 (60.0{\%}) with an ovarian cancer, 8 (20.0{\%}) with a cervical cancer and 8 (20.0{\%}) with an endometrial cancer recurrence. The most frequent site of lymph-nodal recurrence was represented by the aortic region (47.5{\%}), while 18 patients (45.0{\%}) experiencing pelvic lymph-nodal recurrence, 2 (5.0{\%}) both pelvic and aortic relapse, and only 1 (2.5{\%}) had an hepato-celiac lymph node recurrence. No patient required a laparotomic conversion. Median operative time was 220 min, median EBL was 80 mL, and median post-operative hospital stay was 2 days. There were 2 (5.0{\%}) intra-operative and 4 (10.0{\%}) post-operative complications, of which 2 were grade 3. The median follow-up was 22.5 months, and during this time 15 patients showed another relapse with a median time to progression of 12 months. Seven women died because of the disease. The 2-year post-relapse disease-free survival (PR-DFS) was 54.7{\%}, and the 2-year post-relapse overall survival (PR-OS) was 79.3{\%}. Conclusions: In our experience minimally invasive surgery is a valid therapeutic approach in very select patients with localized lymph-nodal recurrence of gynecological cancers, with benefits about peri and post-operative morbidities and without compromising their oncological outcome.",
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AU - D'Indinosante, Marco

AU - Federico, Alex

AU - Tortorella, Lucia

AU - Carbone, Maria Vittoria

AU - Gueli Alletti, Salvatore

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