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01-09-2016 | Gynecologic Oncology

Prospective Randomized Trial Comparing Transperitoneal Versus Extraperitoneal Laparoscopic Aortic Lymphadenectomy for Surgical Staging of Endometrial and Ovarian Cancer: The STELLA Trial

Authors: Berta Díaz-Feijoo, MD, PhD, Alejandro Correa-Paris, MD, Assumpció Pérez-Benavente, MD, PhD, Silvia Franco-Camps, MD, José Luis Sánchez-Iglesias, MD, PhD, Silvia Cabrera, MD, PhD, Javier de la Torre, MD, PhD, Cristina Centeno, MD, Oriol Puig Puig, MD, Blanca Gil-Ibañez, MD, PhD, Eva Colas, PhD, Javier Magrina, MD, Antonio Gil-Moreno, MD, PhD

Published in: Annals of Surgical Oncology | Issue 9/2016

Abstract

Background

There is an ongoing debate on which approach, transperitoneal or extraperitoneal, is superior for the performance of laparoscopic aortic lymphadenectomy (LPA-LND) for the surgical staging of gynecologic cancer. A prospective randomized trial (STELLA trial) was designed to compare the perioperative outcomes and node retrieval of extraperitoneal versus transperitoneal aortic lymphadenectomy by laparoscopy or robot-assisted laparoscopy.

Methods

Patients with endometrial or ovarian carcinoma requiring aortic lymphadenectomy for surgical staging were randomized to an extraperitoneal or transperitoneal approach by laparoscopy or robot-assisted laparoscopy between June 2012 and July 2014.

Results

A total of 60 patients were entered into the study, 48 with endometrial cancer (80 %) and 12 with ovarian cancer (20 %). Thirty-one patients (51.6 %) were randomly assigned to the extraperitoneal group and 29 to the transperitoneal group (48.3 %). The means LPA-LND operating time was 90 min in both group (p = 0.343). The mean (range) blood loss was 105 (10–400) mL for extraperitoneal versus 100 (5–1000) mL for transperitoneal group (p = 0.541). There were no differences in the number of collected lymph nodes between the two groups [median (range) for extraperitoneal 12 (4–41) vs. 13 (4–29) for transperitoneal (p = 0.719)].

Conclusions

The extraperitoneal and transperitoneal approaches for laparoscopic and robotic aortic lymphadenectomy provide similar perioperative outcomes and nodal yields. Trial registration: The STELLA trial is registered at the US National Institutes of Health (ClinicalTrials.gov) #NCT01810874.

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Title: Prospective Randomized Trial Comparing Transperitoneal Versus Extraperitoneal Laparoscopic Aortic Lymphadenectomy for Surgical Staging of Endometrial and Ovarian Cancer: The STELLA Trial
Authors: Berta Díaz-Feijoo, MD, PhD
Alejandro Correa-Paris, MD
Assumpció Pérez-Benavente, MD, PhD
Silvia Franco-Camps, MD
José Luis Sánchez-Iglesias, MD, PhD
Silvia Cabrera, MD, PhD
Javier de la Torre, MD, PhD
Cristina Centeno, MD
Oriol Puig Puig, MD
Blanca Gil-Ibañez, MD, PhD
Eva Colas, PhD
Javier Magrina, MD
Antonio Gil-Moreno, MD, PhD
Publication date: 01-09-2016
Publisher: Springer International Publishing
Published in: Annals of Surgical Oncology / Issue 9/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-016-5229-9

At a glance: The STEP trials

Springer Medicine

Prospective Randomized Trial Comparing Transperitoneal Versus Extraperitoneal Laparoscopic Aortic Lymphadenectomy for Surgical Staging of Endometrial and Ovarian Cancer: The STELLA Trial

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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