Laparoscopic abdominal staging in locally advanced cervical cancer

In order to determine patterns of peritoneal spread in locally advanced cer vical cancer, 59 patients with previously untreated stages IB and IIA tumor size > 4 cm, IIB, III and IVA cervical cancer were considered for laparosc opic abdominal staging. Fifty-six patients (95%) were considered suitable a nd underwent laparoscopy. Peritoneal spread was found in 15 (27%) patients. The location was pelvic in nine (17%), extra-pelvic in one (2%), both pelv ic and extra-pelvic in four (8%), Peritoneal washing was positive in five ( 9%) patients, being the unique site of peritoneal spread in one, Overall, 1 6 (29%) patients had evidence of abdominal disease. The median number of po sitive sites was one (range 1-4); uterine serosa was positive in nine (17%) patients, pre-vesical peritoneum in seven (13%), Douglas peritoneum in fiv e (10%), paracolic gutter in three (6%), adnexa and omentum in two (4%), an d sigmoid serosa in one (2%) patient. One operative complication occurred a nd all patients were discharged the day after the procedure. To date, with a median follow-up of 27 months (range 7-38), no metastasis has been detect ed at the trocar insertion sites, To summarize, laparoscopic staging in loc ally advanced cervical cancer is a safe, feasible and simple technique whic h is able to accurately detect abdominal disease.