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Incidence of sentinel lymph node metastases in apparent early-stage endometrial cancer: a multicenter observational study.
De Vitis, Luigi Antonio; Fumagalli, Diletta; Schivardi, Gabriella; Capasso, Ilaria; Grcevich, Leah; Multinu, Francesco; Cucinella, Giuseppe; Occhiali, Tommaso; Betella, Ilaria; Guillot, Benedetto E; Pappalettera, Giulia; Shahi, Maryam; Fought, Angela J; McGree, Michaela; Reynolds, Evelyn; Colombo, Nicoletta; Zanagnolo, Vanna; Aletti, Giovanni; Langstraat, Carrie; Mariani, Andrea; Glaser, Gretchen.
Afiliación
  • De Vitis LA; Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA.
  • Fumagalli D; Department of Gynecology, IEO, European Institute of Oncology IRCCS, Milan, Italy.
  • Schivardi G; Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA.
  • Capasso I; Department of Obstetrics and Gynecology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
  • Grcevich L; Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA.
  • Multinu F; Department of Gynecology, IEO, European Institute of Oncology IRCCS, Milan, Italy.
  • Cucinella G; Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA.
  • Occhiali T; Department of Obstetrics and Gynecology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
  • Betella I; Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA.
  • Guillot BE; Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA.
  • Pappalettera G; Department of Gynecology, IEO, European Institute of Oncology IRCCS, Milan, Italy.
  • Shahi M; Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA.
  • Fought AJ; Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Palermo, Italy.
  • McGree M; Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA.
  • Reynolds E; Clinic of Obstetrics and Gynecology, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.
  • Colombo N; Department of Gynecology, IEO, European Institute of Oncology IRCCS, Milan, Italy.
  • Zanagnolo V; Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA.
  • Aletti G; Faculty of Medicine and Surgery, University of Milan, Milan, Italy.
  • Langstraat C; Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA.
  • Mariani A; Faculty of Medicine and Surgery, University of Milan, Milan, Italy.
  • Glaser G; Department of Pathology, Mayo Clinic, Rochester, Minnesota, USA.
Int J Gynecol Cancer ; 34(5): 689-696, 2024 May 06.
Article en En | MEDLINE | ID: mdl-38514100
ABSTRACT

OBJECTIVE:

Ultrastaging is accurate in detecting nodal metastases, but increases costs and may not be necessary in certain low-risk subgroups. In this study we examined the risk of nodal involvement detected by sentinel lymph node (SLN) biopsy in a large population of apparent early-stage endometrial cancer and stratified by histopathologic characteristics. Furthermore, we aimed to identify a subgroup in which ultrastaging may be omitted.

METHODS:

We retrospectively included patients who underwent SLN (with bilateral mapping and no empty nodal packets on final pathology) ± systematic lymphadenectomy for apparent early-stage endometrial cancer at two referral cancer centers. Lymph node status was determined by SLN only, regardless of non-SLN findings. The incidence of macrometastasis, micrometastasis, and isolated tumor cells (ITC) was measured in the overall population and after stratification by histotype (endometrioid vs serous), myometrial invasion (none, <50%, ≥50%), and grade (G1, G2, G3).

RESULTS:

Bilateral SLN mapping was accomplished in 1570 patients 1359 endometrioid and 211 non-endometrioid, of which 117 were serous. The incidence of macrometastasis, micrometastasis, and ITC was 3.8%, 3.4%, and 4.8%, respectively. In patients with endometrioid histology (n=1359) there were 2.9% macrometastases, 3.2% micrometastases, and 5.3% ITC. No macro/micrometastases and only one ITC were found in a subset of 274 patients with low-grade (G1-G2) endometrioid endometrial cancer without myometrial invasion (all <1%). The incidence of micro/macrometastasis was higher, 2.8%, in 708 patients with low-grade endometrioid endometrial cancer invading <50% of the myometrium. In patients with serous histology (n=117), the incidence of macrometastases, micrometastasis, and ITC was 11.1%, 6.0%, and 1.7%, respectively. For serous carcinoma without myometrial invasion (n=36), two patients had micrometastases for an incidence of 5.6%.

CONCLUSIONS:

Ultrastaging may be safely omitted in patients with low-grade endometrioid endometrial cancer without myometrial invasion. No other subgroups with a risk of nodal metastasis of less than 1% have been identified.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Endometriales / Biopsia del Ganglio Linfático Centinela / Ganglio Linfático Centinela / Metástasis Linfática / Estadificación de Neoplasias Límite: Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Revista: Int J Gynecol Cancer Asunto de la revista: GINECOLOGIA / NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Endometriales / Biopsia del Ganglio Linfático Centinela / Ganglio Linfático Centinela / Metástasis Linfática / Estadificación de Neoplasias Límite: Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Revista: Int J Gynecol Cancer Asunto de la revista: GINECOLOGIA / NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido