Sistema de Salut de Catalunya
Institut Català de la Salut
[Cabrera S, Gómez-Hidalgo NR, Bebia V, Gil-Moreno A] Unitat de Ginecologia Oncològica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [García-Pineda V] Gynecologic Oncology Unit, La Paz University Hospital, Madrid, Spain. [Fernández-González S] Unitat de Ginecologia Oncològica, Hospital Universitari de Bellvitge, Barcelona, Spain. [Alonso P] Department of Obstetrics and Gynecology, Hospital Universitario Gregorio Marañón, Madrid, Spain
Vall d'Hebron Barcelona Hospital Campus
2023-10-11T12:30:42Z
2023-10-11T12:30:42Z
2023-11
Accuracy; Sentinel lymph node biopsy; Endometrial cancer
Precisión; Biopsia del ganglio linfático centinela; Cáncer de endometrio
Precisió; Biòpsia del gangli limfàtic sentinella; Càncer d'endometri
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.
Open Access Funding provided by Universitat Autonoma de Barcelona.
Article
Versió publicada
Anglès
Endometri - Càncer - Diagnòstic; Nodes limfàtics; Biòpsia; DISEASES::Neoplasms::Neoplasms by Site::Urogenital Neoplasms::Genital Neoplasms, Female::Uterine Neoplasms::Endometrial Neoplasms; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Cytological Techniques::Cytodiagnosis::Biopsy::Sentinel Lymph Node Biopsy; ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias urogenitales::neoplasias de los genitales femeninos::neoplasias uterinas::neoplasias endometriales; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::técnicas de laboratorio clínico::técnicas citológicas::citodiagnóstico::biopsia::biopsia del ganglio linfático centinela
Springer
Annals of Surgical Oncology;30
https://doi.org/10.1245/s10434-023-14065-3
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
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