Evaluating long-term outcomes of three approaches to retroperitoneal staging in endometrial cancer.

Bogani, Giorgio; Di Donato, Violante; Papadia, Andrea; Buda, Alessandro; Casarin, Jvan; Multinu, Francesco; Plotti, Francesco; Cuccu, Ilaria; D'Auge, Tullio Golia; Gasparri, Maria Luisa; Pinelli, Ciro; Perrone, Anna Myriam; Barra, Fabio; Sorbi, Flavia; Cromi, Antonella; Di Martino, Giampaolo; Palaia, Innocenza; Perniola, Giorgia; Ferrero, Simone; De Iaco, Pierandrea; ... (2022). Evaluating long-term outcomes of three approaches to retroperitoneal staging in endometrial cancer. Gynecologic oncology, 166(2), pp. 277-283. Elsevier 10.1016/j.ygyno.2022.06.007

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OBJECTIVE

Sentinel lymph node mapping (SNM) has gained popularity in managing apparent early-stage endometrial cancer (EC). Here, we evaluated the long-term survival of three different approaches of nodal assessment.

METHODS

This is a multi-institutional retrospective study evaluating long-term outcomes of EC patients having nodal assessment between 01/01/2006 and 12/31/2016. In order to reduce possible confounding factors, we applied a propensity-matched algorithm.

RESULTS

Overall, 940 patients meeting inclusion criteria were included in the study, of which 174 (18.5%), 187 (19.9%), and 579 (61.6%) underwent SNM, SNM followed by backup lymphadenectomy (LND) and LND alone, respectively. Applying a propensity score matching algorithm (1:1:2) we selected 500 patients, including 125 SNM, 125 SNM/backup LND, and 250 LND. Baseline characteristics of the study population were similar between groups. The prevalence of nodal disease was 14%, 16%, and 12% in patients having SNM, SNM/backup LND and LND, respectively. Overall, 19 (7.6%) patients were diagnosed with low volume nodal disease. The survival analysis comparing the three techniques did not show statistical differences in terms of disease-free (p = 0.750) and overall survival (p = 0.899). Similarly, the type of nodal assessment did not impact survival outcomes after stratification based on uterine risk factors.

CONCLUSION

Our study highlighted that SNM provides similar long-term oncologic outcomes than LND.

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