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

9 Scopus citations

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

ASJC Scopus subject areas

  • Surgery
  • Oncology

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    Díaz-Feijoo, B., Correa-Paris, A., Pérez-Benavente, A., Franco-Camps, S., Sánchez-Iglesias, J. L., Cabrera, S., de la Torre, J., Centeno, C., Puig, O. P., Gil-Ibañez, B., Colas, E., Magrina, J., & Gil-Moreno, A. (Accepted/In press). 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, 1-9. https://doi.org/10.1245/s10434-016-5229-9