[Laterally extended parametrectomy in cases with cervical carcinoma]

Area of Science:

• Gynecologic Oncology
• Surgical Oncology
• Cervical Cancer Treatment

Context:

• Clinical staging of cervical carcinoma, particularly with parametrial involvement (Stage IIB), presents challenges in therapeutic approach selection.
• Standard radical hysterectomy may have limitations in dissecting lateral parametria.
• Laterally Extended Parametrectomy (LEP), introduced in 1993, facilitates comprehensive removal of pelvic connective and lymphatic tissues.

Purpose:

• To evaluate the efficacy and application of Laterally Extended Parametrectomy (LEP) in radical hysterectomy for cervical cancer.
• To assess the surgical outcomes and pathological findings in patients undergoing LEP.
• To present LEP as an alternative surgical treatment for locally advanced cervical cancer.

Summary:

• A retro- and prospective study enrolled 17 patients with Stage IB to IIA cervical cancer undergoing radical hysterectomy with unilateral LEP.
• Histological analysis revealed positive iliac lymph nodes in 14 patients and positive paraaortic lymph nodes in 4 out of 6 cases.
• Parametrial infiltration was observed in 6 patients, with 3 cases showing bilateral involvement, and 8 patients had unilateral hydroureter.

Impact:

• Laterally Extended Parametrectomy (LEP) enables complete resection of lymphatic and connective tissues to the pelvic sidewall.
• LEP provides an effective surgical option for locally advanced cervical cancer, including Stage IIB cases with positive lymph nodes.
• This technique offers a viable alternative to conservative therapies like chemoradiation for select cervical cancer patients.