Skip to main content

Laparoscopic Reoperative Surgery for Incompletely Staged Gynecologic Malignancies

  • Chapter
  • First Online:
Reoperative Pelvic Surgery
  • 816 Accesses

Abstract

Despite published recommendations for gynecologic oncology consultation in patients with endometrial cancer or suspicious adnexal masses, patients still undergo surgical evaluation for these conditions in settings where surgical staging is either not immediately available or not performed.1 In addition, although recent Pap smear evaluation is a standard prerequisite for hysterectomy, this operation is occasionally performed either in the absence of recent cervical cytologic evaluation or in the context of false-negative cervical cytologic evaluation or known cervical dysplasia, leading to the discovery of occult cervical cancer on pathologic evaluation of the uterus.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Guidelines for Referral to a Gynecologic Oncologist: rationale and benefits. Gynecol Oncol. 2000;78:S1–S13.

    Article  Google Scholar 

  2. Querleu D, LaBlanc E, Castelain B. Laparoscopic pelvic lymphadenectomy in staging of early carcinoma of the cervix. Am J Obstet Gynecol. 1991;164:579.

    CAS  PubMed  Google Scholar 

  3. Childers JM, Surwit EA. Combined laparoscopic vaginal surgery for the management of two cases of stage I endometrial carcinoma. Gynecol Oncol. 1992;45:46–51.

    Article  CAS  PubMed  Google Scholar 

  4. Mikuta JJ. International Federation of Gynecology and Obstetrics staging of endometrial cancer 1988. Cancer 1993;71(4 Suppl):1460–3.

    CAS  PubMed  Google Scholar 

  5. Boronow RC, Morrow CP, Creasman WT, Disaia PJ, Silverberg SG, Miller A, Blessing JA. Surgical staging in endometrial cancer: Clinical-pathologic findings of a prospective study. Obstet Gynecol. 1984;63(6):825–32.

    CAS  PubMed  Google Scholar 

  6. Creasman WT, Morrow CP, Bundy BN, Homesley HD, Graham JE, Heller PB. Surgical pathological spread pattern of endometrial carcinoma: A gynecologic oncology group study. Cancer 1987;60:2035–41.

    Article  CAS  PubMed  Google Scholar 

  7. Moore DH, Fowler WC, Walton LA, Droegemuller W. Morbidity of lymph node sampling in cancers of the uterine corpus and cervix. Obstet Gynecol. 1989;74:180.

    CAS  PubMed  Google Scholar 

  8. Orr JW, Holloway RW, Orr PF, Holimon JL. Surgical staging of uterine cancer: an analysis of perioperative morbidity. Gynecol Oncol. 1991;42:209.

    Article  PubMed  Google Scholar 

  9. Cohn DE, Huh WK, Fowler JM, Straughn JM. Cost-effectiveness analysis of strategies for the surgical management of grade 1 endometrial adenocarcinoma. Obstet Gynecol. 2007;109(6):1388–95.

    Article  PubMed  Google Scholar 

  10. Orr J, Chamberlain D, Kilgore L, Naumann W, Walker J, Berek J. Management of endometrial cancer. ACOG Practice Bulletin 2005; Number 65.

    Google Scholar 

  11. Naumann RW, Coleman RL. The use of adjuvant radiation therapy in early endometrial cancer by members of the Society of Gynecologic Oncologists in 2005. Gynecol Oncol. 2007;105(1):7–12.

    Article  PubMed  Google Scholar 

  12. Havrilesky LJ, Cragun JM, Calingaert B, Synan I, Secord AA, Soper JT, Clarke-Pearson DL, Berchuck A. Resection of lymph node metastases influences survival in stage IIIC endometrial cancer. Gynecol Oncol. 2005;99(3):689–95.

    Article  PubMed  Google Scholar 

  13. Chan JK, Cheung MK, Huh WK, Osann K, Husain A, Teng NN, Kapp DS. Therapeutic role of lymph node resection in endometrioid corpus cancer: a study of 12,333 patients. Cancer. 2006;107(8):1823–30.

    Article  PubMed  Google Scholar 

  14. Randall ME, Filiaci VL, Muss H, Spirtos NM, Mannel RS, Fowler J, Thigpen JT, Benda JA. Gynecologic Oncology Group Study. Randomized phase III trial of whole-abdominal irradiation versus doxorubicin and cisplatin chemotherapy in advanced endometrial carcinoma: a Gynecologic Oncology Group Study. J Clin Oncol. 2006;24(1):36–44.

    Article  CAS  PubMed  Google Scholar 

  15. Childers JM, Brzechffa PR, Hatch KD, Surwit EA. Laparoscopic assisted surgical staging (LASS) of endometrial carcinoma. Gynecol Oncol. 1993;51:33–8.

    Article  CAS  PubMed  Google Scholar 

  16. Childers JM, Hatch KD, Tran A-N, Surwit EA. Laparoscopic para-aortic lymphadnectomy in gynecologic malignancies. Obstet Gynecol. 1993;82:741–7.

    CAS  PubMed  Google Scholar 

  17. Querleu D. Laparoscopic paraaortic node sampling in gynecologic oncology: A preliminary experience. Gynecol Oncol. 1993;49:24–9.

    Article  CAS  PubMed  Google Scholar 

  18. Childers JM, Spirtos NM, Braiverd P, Surwit EA. Laparoscopic staging of the patient with incompletely-staged early adenocarcinoma of the endometrium. Obstet Gynecol. 1994;83:597.

    Article  CAS  PubMed  Google Scholar 

  19. Spirtos NM, Schlaerth JB, Spirtos TW, Schlaerth AC, Indman PD, Kimball RE. Laparoscopic bilateral pelvic and paraaortic lymph node sampling: an evolving technique. Am J Obstet Gynecol. 1995;173:105–111.

    Article  CAS  PubMed  Google Scholar 

  20. Possover M, Krause N, Plaul K, Kühne-Heid R, Schneider A. Laparoscopic para-aortic and pelvic lymphadenectomy: experience with 150 patients and review of the literature. Gynecol Oncol. 1998;71(1):19–28.

    Article  CAS  PubMed  Google Scholar 

  21. Creasman WT. The role of the generalist obstetrician-gynecologist in the early detection of ovarian cancer. ACOG Comm Opin. 2002;280:2.

    Google Scholar 

  22. Berman M, Randall-Whitis L. Management of adnexal masses. ACOG Pract Bull. 2007;83:7.

    Google Scholar 

  23. Young RC, Decker DG, Wharton JT, Piver MS, Sindelar WF, Edwards BK, Smith JP. Staging laparotomy in early ovarian cancer. JAMA. 1983; 250(22):3072–6.

    Article  CAS  PubMed  Google Scholar 

  24. Chen SS, Lee L. Incidence of para-aortic and pelvic lymph node metastases in epithelial carcinoma of the ovary. Gynecol Oncol. 1983;16(1):95–100.

    Article  CAS  PubMed  Google Scholar 

  25. Helewa ME, Krepart GV, Lotocki R. Staging laparotomy in early epithelial ovarian carcinoma. Am J Obstet Gynecol. 1986;154(2):282–6.

    CAS  PubMed  Google Scholar 

  26. Soper JT, Johnson P, Johnson V, Berchuck A, Clarke-Pearson DL. Comprehensive restaging laparotomy in women with apparent early ovarian carcinoma. Obstet Gynecol. 1992;80(6):949–53.

    CAS  PubMed  Google Scholar 

  27. EA Stier, RR Barakat, JP Curtin, CL Brown, WB Jones, WJ Hoskins. Laparotomy to complete staging of presumed early ovarian cancer. Obstet Gynecol. 1996;87:737–40.

    Article  Google Scholar 

  28. Morice P, Joulie F, Camatte S, Atallah D, Rouzier R, Pautier P, Pomel C, Lhommé C, Duvillard P, Castaigne D. Lymph node involvement in epithelial ovarian cancer: Analysis of 276 pelvic and paraaortic lymphadenectomies and surgical implications. J Am Coll Surg. 2003;197(2):198–205.

    Article  PubMed  Google Scholar 

  29. Cass I, Li AJ, Runowicz CD, Fields AL, Goldberg GL, Leuchter RS, Lagasse LD, Karlan BY. Pattern of lymph node metastases in clinically unilateral stage I invasive epithelial ovarian carcinomas. Gynecol Oncol. 2001;80(1):56–61.

    Article  CAS  PubMed  Google Scholar 

  30. Reich H, McGlynn F, Wilkie W. Laparoscopic management of stage I ovarian cancer. A case report. J Reprod Med. 1990;35(6):601–4.

    CAS  Google Scholar 

  31. Querleu D, Leblanc E. Laparoscopic infrarenal paraaortic lymph node dissection for restaging of carcinoma of the ovary or fallopian tube. Cancer. 1994;73:1467–71.

    Article  CAS  PubMed  Google Scholar 

  32. Childers JM, Lang J, Surwit EA, Hatch KD. Laparoscopic surgical staging of ovarian cancer. Gynecol Oncol. 1995;59:25–33.

    Article  CAS  PubMed  Google Scholar 

  33. Pomel C, Provencher D, Dauplat J, Gauthier P, Le Bouedec G, Drouin P, Audet Lapointe P, Dubuc Lissoir J. Laparoscopic staging of early ovarian cancer. Gynecol Oncol. 1995;58:301–306.

    Article  CAS  PubMed  Google Scholar 

  34. Spirtos NM, Eisekop SM, Boike G, Schlaerth JB, Cappellari JO. Laparoscopic staging in patients with incompletely staged cancers of the uterus, ovary, fallopian tube, and primary peritoneum: a Gynecologic Oncology Group (GOG) study. Am J Obstet Gynecol. 2005;193(5):1645–9.

    Article  PubMed  Google Scholar 

  35. Lehner R, Wenzl R, Heinzl H, Husslein P, Sevelda P. Influence of delayed staging laparotomy after laparoscopic removal of ovarian masses later found malignant. Obstet Gynecol. 1998;92:967–71.

    Article  CAS  PubMed  Google Scholar 

  36. Maiman M, Seltzer V, Boyce J. Laparoscopic Excision of Ovarian Neoplasms Subsequently Found to Be Malignant. Obstet Gynecol. 1991;77:563–5.

    CAS  PubMed  Google Scholar 

  37. Chi DS, Abu-Rustum NR, Sonoda Y, Ivy J, Rhee E, Moore K, Levine DA, Barakat RR. The safety and efficacy of laparoscopic surgical staging of apparent stage I ovarian and fallopian tube cancers. Am J Obstet Gynecol. 2005;192(5):1614–9.

    Article  PubMed  Google Scholar 

  38. Leblanc E, Querleu D, Narducci F, Occelli B, Papageorgiou T, Sonoda Y. Laparoscopic restaging of early stage invasive adnexal tumors: a 10-year experience. Gynecol Oncol. 2004;94(3):624–9.

    Article  CAS  PubMed  Google Scholar 

  39. Querleu D, Papageorgiou T, Lambaudie E, Sonoda Y, Narducci F, LeBlanc E. Laparoscopic restaging of borderline ovarian tumours: results of 30 cases initially presumed as stage IA borderline ovarian tumours. BJOG. 2003;110(2):2.

    Google Scholar 

  40. Daraï E, Tulpin L, Prugnolle H, Cortez A, Dubernard G. Laparoscopic restaging of borderline ovarian tumors. Surg Endosc. 2007;21(11):2039–43.

    Article  PubMed  Google Scholar 

  41. Husain A, Chi DS, Prasad M, Abu-Rustum N, Barakat RR, Brown CL, Poynor EA, Hoskins WJ, Curtin JP. The role of laparoscopy in second-look evaluations for ovarian cancer. Gynecol Oncol. 2001 Jan;80(1):44–7.

    Article  CAS  PubMed  Google Scholar 

  42. Clough KB, Ladonne JM, Nos C, Renolleau C, Validire P, Durand JC.Second look for ovarian cancer: Laparoscopy or Laparotomy? A prospective comparative study. Gynecol Oncol. 1999;72(3):411–7.

    Article  CAS  PubMed  Google Scholar 

  43. Littell RD, Hallonquist H, Matulonis U, Seiden MV, Berkowitz RS, Duska LR. Negative laparoscopy is highly predictive of negative second-look laparotomy following chemotherapy for ovarian, tubal, and primary peritoneal carcinoma. Gynecol Oncol. 2006 Nov;103(2):570–4. Epub 2006 Jun 12.

    Article  PubMed  Google Scholar 

  44. Lacey CG, Morrow CP, Disaia PJ, Lucas WE. Laparoscopy in the evaluation of gynecologic cancer. Obstet Gynecol. 1978 Dec;52(6):708–12.

    CAS  PubMed  Google Scholar 

  45. Childers JM, Hatch KD, Surwit EA. The role of laparoscopic lymphadenectomy in the management of cervical carcinoma. Gynecol Oncol. 1992;47:38–43.

    Article  CAS  PubMed  Google Scholar 

  46. Fowler JM, Carter JR, Carlson JW, et al. Lymph node yield from laparoscopic lymphadenectomy in cervical cancer: a comparative study. Gynecol Oncol. 1993;51:187.

    Article  CAS  PubMed  Google Scholar 

  47. Chu KK, Chang SD, Chen FP, Soong YK. Laparoscopic surgical staging in cervical cancer—preliminary experience among Chinese. Gynecol Oncol. 1997;64:49–53.

    Article  CAS  PubMed  Google Scholar 

  48. Querleu D, Dargent D, Ansquer Y, Leblanc E, Narducci F. Extraperitoneal endosurgical aortic and common iliac dissection in the staging of bulky or advanced cervical carcinomas. Cancer. 2000 Apr 15;88(8):1883–91.

    Article  CAS  PubMed  Google Scholar 

  49. Magrina JF, Walter AJ, Schild SE. Laparoscopic radical parametrectomy and pelvic and aortic lymphadenectomy for vaginal carcinoma: A case report. Gynecol Oncol. 1999 Dec;75(3):514–6.

    Article  CAS  PubMed  Google Scholar 

  50. Lee YS, Lee TH, Koo TB, Cho YL, Park IS. Laparoscopic-assisted radical parametrectomy including pelvic and/or paraaortic lymphadenectomy in women after prior hysterectomy-three cases. Gynecol Oncol. 2003 Dec;91(3):619–22.

    Article  PubMed  Google Scholar 

  51. Fleisch MC, Hatch KD. Laparoscopic assisted parametrectomy/upper vaginectomy (LPUV)-technique, applications and results. Gynecol Oncol. 2005 Sep;98(3):420–6.

    Article  PubMed  Google Scholar 

  52. Liang Z, Xu H, Chen Y, Li Y, Chang Q, Shi C. Laparoscopic radical trachelectomy or parametrectomy and pelvic and para-aortic lymphadenectomy for cervical or vaginal stump carcinoma: report of six cases. Int J Gynecol Cancer. 2006 Jul–Aug;16(4):1713–6.

    Article  CAS  PubMed  Google Scholar 

  53. Nezhat F, Prasad Hayes M, Peiretti M, Rahaman J. Laparoscopic radical parametrectomy and partial vaginectomy for recurrent endometrial cancer. Gynecol Oncol. 2007 Feb;104(2):494–6. Epub 2006 Dec 8.

    Article  PubMed  Google Scholar 

  54. Sedlis A, Bundy BN, Rotman MZ, Lentz SS, Muderspach LI, Zaino RJ. A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage IB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: A Gynecologic Oncology Group Study. Gynecol Oncol. 1999 May;73(2):177–83.

    Article  CAS  PubMed  Google Scholar 

  55. Herd J, Fowler JM, Shenson D, Lacy S, Montz FJ. Laparoscopic para-aortic lymph node sampling: development of a technique. Gynecol Oncol. 1992;44:271.

    Article  CAS  PubMed  Google Scholar 

  56. Dottino PR, Tobias DH, Beddoe A, Golden AL, Cohen CJ. Laparoscopic lymphadenectomy for gynecologic malignancies. Gynecol Oncol. 1999 Jun;73(3):383–8.

    Article  CAS  PubMed  Google Scholar 

  57. Scribner DR Jr, Walker JL, Johnson GA, McMeekin SD, Gold MA, Mannel RS. Laparoscopic pelvic and paraaortic lymph node dissection: analysis of the first 100 cases. Gynecol Oncol. 2001 Sep;82(3):498–503

    Article  PubMed  Google Scholar 

  58. Vasilev SA, McGonigle KF. Extraperitoneal laparoscopic paraaortic lymph node dissection: development of a technique. J Laparoendosc Surg. 1995 Apr;5(2):85–90.

    CAS  PubMed  Google Scholar 

  59. Fowler JM, Hartenbach EM, Reynolds HT, Borner J, Carter JR, Carlson JW, Twiggs LB, Carson LF. Pelvic adhesion formation after pelvic lymphadenectomy: comparison between transperitoneal laparoscopy and extraperitoneal laparotomy in a porcine model. Gynecol Oncol. 1994 Oct;55(1):25–8.

    Article  CAS  PubMed  Google Scholar 

  60. Vasilev SA, McGonigle KF. Extraperitoneal laparoscopic para-aortic lymph node dissection. Gynecol Oncol. 1996 Jun;61(3):315–20.

    Article  CAS  PubMed  Google Scholar 

  61. Falcone T, Goldberg J, Garcia-Ruiz A, Margossian H, Stevens L. Full robotic assistance for laparoscopic tubal anastamosis: a case report. J Laparoendosc Surg. 1999;9(1):107–113.

    Article  CAS  Google Scholar 

  62. Diaz-Arrastia C, Jurnalov C, Gomez G, et al. Laparoscopic hysterectomy using a computer-enhanced surgical robot. Surg Endosc. 2002;16:1271–3.

    Article  CAS  PubMed  Google Scholar 

  63. Elliott DS, Frank I, DiMarco DS, et al. Gynecologic use of robotically assisted laparoscopy: sacrocolpopexy for the treatment of high-grade vaginal vault prolapsed. Am J Surg 2004;188(Suppl to October 2004):52S–56S.

    Article  PubMed  Google Scholar 

  64. Advincula AP, Song A, Burke W, et al. Preliminary experience with robot-assisted laparoscopic myomectomy. J Am Assoc Gynecol Laparosc. 2004 Nov;11(4):511–8.

    Article  PubMed  Google Scholar 

  65. Beste TM, Nelson KH, Daucher JA. Total laparoscopic hysterectomy utilizing a robotic surgical system. JSLS. 2005;9:13–5.

    PubMed  Google Scholar 

  66. Reynolds RK, Burke WM, Advincula AP. Preliminary experience with robot-assisted laparoscopic staging of gynecologic malignancies. JSLS 2005;9:149–58.

    PubMed  Google Scholar 

  67. Sert BM, Abeler VM. Robotic-assisted laparoscopic radical hysterectomy (Piver type III) with pelvic node dissection–case report. Eur J Gynaecol Oncol. 2006;27(5):531–3.

    CAS  PubMed  Google Scholar 

  68. Sert B, Abeler V. Robotic radical hysterectomy in early-stage cervical carcinoma patients, comparing results with total laparoscopic radical hysterectomy cases. The future is now? Int J Med Robot. 2007;3:224–228

    CAS  PubMed  Google Scholar 

  69. Boggess J, Gehrig P, Rutledge T, et al. Robotic type III radical hysterectomy with pelvic lymph-node dissection: description of a novel technique for treating stage Ib1 cervical cancer. SGO 37th Annual Meeting 2006; Abstract #38.

    Google Scholar 

  70. Veljovich D, Paley P, Drescher C, Everett E, Shah C, Peters W. Robotic surgery in gynecologic oncology: program initiation and outcomes after the first year with comparison with laparotomy for endometrial cancer staging. Am J Obstet Gynecol 2008;198:679.e1–679.e10.

    Article  PubMed  Google Scholar 

  71. Walker J, Piedmonte M, Spirtos N, et al. Phase III trial of laparoscopy (scope) vs laparotomy (open) for surgical resection and comprehensive surgical staging of uterine cancer: A Gynecologic Oncology Group (GOG) Study funded by NCI. SGO 37th Annual Meeting 2006; Abstract #22.

    Google Scholar 

  72. Kornblith A, Walker J, Huang H, et al. Quality of life (QOL) of patients in a randomized clinical trial of laparoscopy (scope) vs. open laparotomy (open) for the surgical resection and staging of uterine cancer: A Gynecologic Oncology Group (GOG) study. SGO 37th Annual Meeting 2006; Abstract #47.

    Google Scholar 

  73. Boggess JF, Gehrig PA, Cantrell L, et al. A comparative study of 3 surgical methods for hysterectomy with staging for endometrial cancer: robotic assistance, laparoscopy, laparotomy. Am J Obstet Gynecol. 2008 Oct;199(4):360.e1–9.

    Google Scholar 

  74. Abbou CC, Hoznek A, Salomon L. Laparoscopic radical prostatectomy with a remote controlled robot. J Urol. 2001;165:1964–6.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Veljovich, D.S. (2009). Laparoscopic Reoperative Surgery for Incompletely Staged Gynecologic Malignancies. In: Billingham, R., Kobashi, K., Peters, W. (eds) Reoperative Pelvic Surgery. Springer, New York, NY. https://doi.org/10.1007/b14187_5

Download citation

  • DOI: https://doi.org/10.1007/b14187_5

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-89998-5

  • Online ISBN: 978-0-387-89999-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics