[The future of retroperitoneal lymph node dissection]

Over the past decades, retroperitoneal lymph node dissection has been included in most gynecology oncological surgeries. Today, its usefulness is questioned. Recent studies on cervical, ovarian and endometrial cancer have attempted to redefine the role of retroperitoneal lymph node dissection. Despite theses studies, it appears obvious that dissection only has a minor impact on survival while increasing morbidity to a certain extent. The future of these procedures appears to be related to their prognostic value. The immediate goals today would be to target and remove only the necessary lymph nodes and to decrease the morbidity associated with the procedures. To reach these goals, two new approaches are presently studied: laparoscopic dissection and sentinel lymph node identification.