{'fraction_non_alphanumeric': 0.012285012285012284, 'fraction_numerical': 0.00819000819000819, 'mean_word_length': 5.714285714285714, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Laparoscopic transperitoneal para-aortic debulking surgery in locally advanced cervical carcinoma

The role of lymph node assessment in patients with locally advanced cervical cancer and the impact of the discovery and removal of occult nodal disease is still debated. The value of surgical staging prior to chemoradiation in international guidelines is contradictory, since results published in the literature are controversial, and even the PET scan has a high falsenegative rate for metastatic lymph nodes involvement. Marnitz et al published a randomized trial in 2020 (Uterus11 study) processing this question. Minimally invasive surgical staging in patients with locally advanced cervical cancer has demonstrated upstaging rates between 22% and 43% compared with clinical staging. Studies that specifically search the debulking of macroscopically enlarged lymph nodes show better outcomes for patients in whom enlarged lymph nodes can be removed. The potential oncologic benefit of removing bulky pelvic and paraaortic lymph node metastases prior to primary chemoradiation, from a radiobiological point of view, is to provide higher locoregional control and it allows adaptation of the extent of irradiation fields.