Accuracy and Survival Outcomes after National Implementation of Sentinel Lymph Node Biopsy in Early Stage Endometrial Cancer
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Published:2023-08-26
Issue:12
Volume:30
Page:7653-7662
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ISSN:1068-9265
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Container-title:Annals of Surgical Oncology
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language:en
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Short-container-title:Ann Surg Oncol
Author:
Cabrera SilviaORCID, Gómez-Hidalgo Natalia R., García-Pineda Virginia, Bebia Vicente, Fernández-González Sergi, Alonso Paula, Rodríguez-Gómez Tomás, Fusté Pere, Gracia-Segovia Myriam, Lorenzo Cristina, Chacon Enrique, Roldan Rivas Fernando, Arencibia Octavio, Martí Edo Marina, Fidalgo Soledad, Sanchis Josep, Padilla-Iserte Pablo, Pantoja-Garrido Manuel, Martínez Sergio, Peiró Ricard, Escayola Cecilia, Oliver-Pérez M. Reyes, Aghababyan Cristina, Tauste Carmen, Morales Sara, Torrent Anna, Utrilla-Layna Jesus, Fargas Francesc, Calvo Ana, Aller de Pace Laura, Gil-Moreno Antonio,
Abstract
Abstract
Background
Sentinel lymph node (SLN) biopsy has recently been accepted to evaluate nodal status in endometrial cancer at early stage, which is key to tailoring adjuvant treatments. Our aim was to evaluate the national implementation of SLN biopsy in terms of accuracy to detect nodal disease in a clinical setting and oncologic outcomes according to the volume of nodal disease.
Patients and Methods
A total of 29 Spanish centers participated in this retrospective, multicenter registry including patients with endometrial adenocarcinoma at preoperative early stage who had undergone SLN biopsy between 2015 and 2021. Each center collected data regarding demographic, clinical, histologic, therapeutic, and survival characteristics.
Results
A total of 892 patients were enrolled. After the surgery, 12.9% were suprastaged to FIGO 2009 stages III–IV and 108 patients (12.1%) had nodal involvement: 54.6% macrometastasis, 22.2% micrometastases, and 23.1% isolated tumor cells (ITC). Sensitivity of SLN biopsy was 93.7% and false negative rate was 6.2%. After a median follow up of 1.81 years, overall surivial and disease-free survival were significantly lower in patients who had macrometastases when compared with patients with negative nodes, micrometastases or ITC.
Conclusions
In our nationwide cohort we obtained high sensitivity of SLN biopsy to detect nodal disease. The oncologic outcomes of patients with negative nodes and low-volume disease were similar after tailoring adjuvant treatments. In total, 22% of patients with macrometastasis and 50% of patients with micrometastasis were at low risk of nodal metastasis according to their preoperative risk factors, revealing the importance of SLN biopsy in the surgical management of patients with early stage EC.
Funder
Universitat Autònoma de Barcelona
Publisher
Springer Science and Business Media LLC
Reference27 articles.
1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022;72(1):7–33. https://doi.org/10.3322/caac.21708. 2. Concin N, et al. ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma. Int J Gynecol Cancer. 2020. https://doi.org/10.1136/ijgc-2020-002230. 3. Panici PB, Basile S, Maneschi F, et al. Systematic pelvic lymphadenectomy vs no lymphadenectomy in early-stage endometrial carcinoma: randomized clinical trial. J Natl Cancer Inst. 2008;100(23):1707–16. https://doi.org/10.1093/jnci/djn397. 4. ASTEC study group, Kitchener H, Swart AMC, Qian Q, Amos C, Parmar MKB. Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomised study. Lancet (London, England). 2009;373(9658):125–36. https://doi.org/10.1016/S0140-6736(08)61766-3. 5. Network NCCN, NCCN Clinical Practice Guidelines in oncology, uterine neoplasm. https://www.nccn.org/professionals/physician_gls/pdf/uterine.pdf. Accessed 15 July 2019.
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