Belgian experience of robot assisted laparoscopic para – aortic lymphadenectomy for staging of locally advanced cervical carcinoma. A multicentric study.
; GOFFIN, Frédéric ; et al
Objectives: FIGO clinical staging, imaging techniques sometimes underestimate extension of locally advanced cervical cancer (LACC). The presence of para-aortic lymph node (LN) metastases in LACC ... [more ▼]
Objectives: FIGO clinical staging, imaging techniques sometimes underestimate extension of locally advanced cervical cancer (LACC). The presence of para-aortic lymph node (LN) metastases in LACC identifies patients with poor prognosis. Laparoscopic para-aortic lymphadenectomy is now proposed as a diagnostic tool. Feasibility and safety of robot assisted laparoscopic para-aortic lymphadenectomy has been reported. We collected data from different Belgian centers to assess its oncological safety and complication rate. Study design: Three centers participated in the study. Thirty seven patients with LACC underwent a pre treatment robot assisted laparoscopic para-aortic lymphadenectomy. Data was prospectively collected. Results: The median number of LN collected was 27.5 (1-54) per patient. Five out of 37 patients had para-aortic node metastasis. The false negative rate for PET CT diagnosing para- aortic node metastasis was 10.8% (4/37). We encountered 2 major intra operative complications (5.4%). Post operative morbidity was low (13.5%). Median follow up was 27 months (95% CI 24–30). Median disease free survival (DFS) was 16 months (95% CI 2.4- 29.6). Patients with negative LN had a median DFS of 24 months (NA) although patients with positive LN had a median DFS of 9 months (95% CI 6.9-11.9). Conclusions: In this series we report that robot assisted laparoscopic para-aortic lymphadencetomy provided the surgeon with useful information to avoid understaging in 10.8% of women with LACC, at the expense of low morbidity (13.5%). Presence of microscopic para-aortic LN metastasis is correlated with shorter DFS. The number of patients with positive LN doesn’t allow us to draw any firm conclusion. [less ▲]Detailed reference viewed: 14 (0 ULg)
Familial adenomatous polyposis: clinical presentation, detection and surveillance.
; ; Vander Auwera, Jacqueline et al
in Acta Gastro-Enterologica Belgica (2011), 74(3), 415-20
Colorectal cancer (CRC) is a leading cause of cancer related death in the western countries. It remains an important health problem, often under-diagnosed. The symptoms can appear very late and about 25 ... [more ▼]
Colorectal cancer (CRC) is a leading cause of cancer related death in the western countries. It remains an important health problem, often under-diagnosed. The symptoms can appear very late and about 25% of the patients are diagnosed at metastatic stage. Familial adenomatous polyposis (FAP) is an inherited colorectal cancer syndrome, characterized by the early onset of hundred to thousands of adenomatous polyps in the colon and rectum. Left untreated, there is a nearly 100% cumulative risk of progression to CRC by the age of 35-40 years, as well as an increased risk of various other malignancies. CRC can be prevented by the identification of the high risk population and by the timely implementation of rigid screening programs which will lead to special medico-surgical interventions. [less ▲]Detailed reference viewed: 63 (2 ULg)