The impact of pretreatment staging laparotomy on survival in locally advanced cervical carcinoma

The purpose of this retrospective study was to determine the effect of pretreatment surgical staging on survival of patients with locally advanced cervical carcinoma. Two hundred and seventy-four women with cervical cancer stages IIB-IVA treated with primary radiotherapy comprised the study group. Eighty-nine patients underwent pretreatment staging laparotomy (group 1) and 172 patients underwent clinical staging (group 2). Thirteen patients underwent CT guided biopsy of paraaortic adenopathy. Paraaortic metastases were detected in 12.3% and intraabdominal metastases were found in 4.5% of patients in group 1. Extended field radiotherapy and/or systemic chemotherapy were given in these cases. The median survival of patients in group 1 was statistically longer than that of patients in group 2, 29 months vs 19 months, respectively (p=.01). Multivariate analysis controlling for both stage and age showed pretreatment staging laparotomy is a significant predictor of survival (p=.03). Our data suggest that surgical staging may be beneficial in patients with locally advanced cervical carcinoma.