Laparoskopische pelvine und paraaortale Lymphonodektomie bei einem Zervixkarzinom Stadium FIGO IV B

Cervical cancer is the third most common cancer occurring in women worldwide. The therapy for advanced stage cervical cancer is a particular challenge. There are no evidence-based recommendations for the therapy of advanced cervical cancer FIGO stage IV in the guidelines of the German Working Group on Gynecological Oncology nor in the international literature. Large randomised and prospective studies on treatment are missing. We present a patient with cervical cancer (FIGO stage IV B) with bulky metastatic lymph nodes in the obturator fossae and the paraaortic area. In accordance with existing studies, laparoscopic lymphadenectomy and tumour debulking with excision of the metastases was performed after clinical staging. Postoperatively, radiochemotherapy was initiated with boost in the area of the bulky lymph nodes. Laparoscopic lymphadenectomy improved the prognosis of this patient and is, according to existing studies, superior to laparotomy with regard to convalescence time, blood loss and hospital stay. But it is absolutely necessary that the procedure is performed by an experienced surgeon who is well acquainted with the technique.