Cuccu, Ilaria; Raspagliesi, Francesco; Malzoni, Mario; Vizza, Enrico; Papadia, Andrea; Di Donato, Violante; Giannini, Andrea; De Iaco, Pierandrea; Perrone, Anna Myriam; Plotti, Francesco; Angioli, Roberto; Casarin, Jvan; Ghezzi, Fabio; Cianci, Stefano; Vizzielli, Giuseppe; Restaino, Stefano; Petrillo, Marco; Sorbi, Flavia; Multinu, Francesco; Schivardi, Gabriella; ... (2024). Sentinel node mapping in high-intermediate and high-risk endometrial cancer: Analysis of 5-year oncologic outcomes. European journal of surgical oncology EJSO, 50(4), p. 108018. Elsevier 10.1016/j.ejso.2024.108018
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OBJECTIVE
To assess 5-year oncologic outcomes of apparent early-stage high-intermediate and high-risk endometrial cancer undergoing sentinel node mapping versus systematic lymphadenectomy.
METHODS
This is a multi-institutional retrospective, propensity-matched study evaluating data of high-intermediate and high-risk endometrial cancer (according to ESGO/ESTRO/ESP guidelines) undergoing sentinel node mapping versus systematic pelvic lymphadenectomy (with and without para-aortic lymphadenectomy). Survival outcomes were assessed using Kaplan-Meier and Cox proportional hazard methods.
RESULTS
Overall, the charts of 242 patients with high-intermediate and high-risk endometrial cancer were retrieved. Data on 73 (30.1%) patients undergoing hysterectomy plus sentinel node mapping were analyzed. Forty-two (57.5%) and 31 (42.5%) patients were classified in the high-intermediate and high-risk groups, respectively. Unilateral sentinel node mapping was achieved in all patients. Bilateral mapping was achieved in 67 (91.7%) patients. Three (4.1%) patients had site-specific lymphadenectomy (two pelvic areas only and one pelvic plus para-aortic area), while adjunctive nodal dissection was omitted in the hemipelvis of the other three (4.1%) patients. Sentinel nodes were detected in the para-aortic area in eight (10.9%) patients. Twenty-four (32.8%) patients were diagnosed with nodal disease. A propensity-score matching was used to compare the aforementioned group of patients undergoing sentinel node mapping with a group of patients undergoing lymphadenectomy. Seventy patient pairs were selected (70 having sentinel node mapping vs. 70 having lymphadenectomy). Patients undergoing sentinel node mapping experienced similar 5-year disease-free survival (HR: 1.233; 95%CI: 0.6217 to 2.444; p = 0.547, log-rank test) and 5-year overall survival (HR: 1.505; 95%CI: 0.6752 to 3.355; p = 0.256, log-rank test) than patients undergoing lymphadenectomy.
CONCLUSIONS
Sentinel node mapping does not negatively impact 5-year outcomes of high-intermediate and high-risk endometrial cancer. Further prospective studies are warranted.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology |
UniBE Contributor: |
Mueller, Michael |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1532-2157 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
19 Mar 2024 09:49 |
Last Modified: |
30 Mar 2024 00:15 |
Publisher DOI: |
10.1016/j.ejso.2024.108018 |
PubMed ID: |
38428106 |
Uncontrolled Keywords: |
Endometrial cancer High-risk Intermediate-high risk Sentinel node mapping |
BORIS DOI: |
10.48350/193728 |
URI: |
https://boris.unibe.ch/id/eprint/193728 |
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