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

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

Research output: Contribution to journalArticle

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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.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalAnnals of Surgical Oncology
DOIs
StateAccepted/In press - Apr 20 2016

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Endometrial Neoplasms
Lymph Node Excision
Ovarian Neoplasms
Laparoscopy
Neoplasm Staging
National Institutes of Health (U.S.)
Robotics
Lymph Nodes
Carcinoma

ASJC Scopus subject areas

  • Surgery
  • Oncology

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Prospective Randomized Trial Comparing Transperitoneal Versus Extraperitoneal Laparoscopic Aortic Lymphadenectomy for Surgical Staging of Endometrial and Ovarian Cancer : The STELLA Trial. / Díaz-Feijoo, Berta; Correa-Paris, Alejandro; Pérez-Benavente, Assumpció; Franco-Camps, Silvia; Sánchez-Iglesias, José Luis; Cabrera, Silvia; de la Torre, Javier; Centeno, Cristina; Puig, Oriol Puig; Gil-Ibañez, Blanca; Colas, Eva; Magrina, Javier; Gil-Moreno, Antonio.

In: Annals of Surgical Oncology, 20.04.2016, p. 1-9.

Research output: Contribution to journalArticle

Díaz-Feijoo, B, Correa-Paris, A, Pérez-Benavente, A, Franco-Camps, S, Sánchez-Iglesias, JL, Cabrera, S, de la Torre, J, Centeno, C, Puig, OP, Gil-Ibañez, B, Colas, E, Magrina, J & Gil-Moreno, A 2016, 'Prospective Randomized Trial Comparing Transperitoneal Versus Extraperitoneal Laparoscopic Aortic Lymphadenectomy for Surgical Staging of Endometrial and Ovarian Cancer: The STELLA Trial', Annals of Surgical Oncology, pp. 1-9. https://doi.org/10.1245/s10434-016-5229-9
Díaz-Feijoo, Berta ; Correa-Paris, Alejandro ; Pérez-Benavente, Assumpció ; Franco-Camps, Silvia ; Sánchez-Iglesias, José Luis ; Cabrera, Silvia ; de la Torre, Javier ; Centeno, Cristina ; Puig, Oriol Puig ; Gil-Ibañez, Blanca ; Colas, Eva ; Magrina, Javier ; Gil-Moreno, Antonio. / Prospective Randomized Trial Comparing Transperitoneal Versus Extraperitoneal Laparoscopic Aortic Lymphadenectomy for Surgical Staging of Endometrial and Ovarian Cancer : The STELLA Trial. In: Annals of Surgical Oncology. 2016 ; pp. 1-9.
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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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T1 - Prospective Randomized Trial Comparing Transperitoneal Versus Extraperitoneal Laparoscopic Aortic Lymphadenectomy for Surgical Staging of Endometrial and Ovarian Cancer

T2 - The STELLA Trial

AU - Díaz-Feijoo, Berta

AU - Correa-Paris, Alejandro

AU - Pérez-Benavente, Assumpció

AU - Franco-Camps, Silvia

AU - Sánchez-Iglesias, José Luis

AU - Cabrera, Silvia

AU - de la Torre, Javier

AU - Centeno, Cristina

AU - Puig, Oriol Puig

AU - Gil-Ibañez, Blanca

AU - Colas, Eva

AU - Magrina, Javier

AU - Gil-Moreno, Antonio

PY - 2016/4/20

Y1 - 2016/4/20

N2 - 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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