Published 2021
| Version v1
Publication
Sentinel node mapping vs. sentinel node mapping plus back-up lymphadenectomy in high-risk endometrial cancer patients: Results from a multi-institutional study
Creators
- Bogani G.
- Papadia A.
- Buda A.
- Casarin J.
- Di Donato V.
- Gasparri M. L.
- Plotti F.
- Pinelli C.
- Paderno M. C.
- Lopez S.
- Perrone A. M.
- Barra F.
- Guerrisi R.
- Brusadelli C.
- Cromi A.
- Ferrari D.
- Chiapp V.
- Signorelli M.
- Maggiore U. L. R.
- Ditto A.
- Palaia I.
- Ferrero S.
- De Iaco P.
- Angioli R.
- Panici P. B.
- Ghezzi F.
- Landoni F.
- Mueller M. D.
- Raspagliesi F.
Contributors
Others:
- Bogani, G.
- Papadia, A.
- Buda, A.
- Casarin, J.
- Di Donato, V.
- Gasparri, M. L.
- Plotti, F.
- Pinelli, C.
- Paderno, M. C.
- Lopez, S.
- Perrone, A. M.
- Barra, F.
- Guerrisi, R.
- Brusadelli, C.
- Cromi, A.
- Ferrari, D.
- Chiapp, V.
- Signorelli, M.
- Maggiore, U. L. R.
- Ditto, A.
- Palaia, I.
- Ferrero, S.
- De Iaco, P.
- Angioli, R.
- Panici, P. B.
- Ghezzi, F.
- Landoni, F.
- Mueller, M. D.
- Raspagliesi, F.
Description
Objective: Sentinel node mapping (SLN) has replaced lymphadenectomy for staging surgery in apparent early-stage low and intermediate risk endometrial cancer (EC). Only limited data about the adoption of SNM in high risk EC is still available. Here, we evaluate the outcomes of high-risk EC undergoing SNM (with or without back-up lymphadenectomy). Methods: This is a multi-institutional international retrospective study, evaluating data of high-risk (FIGO grade 3 endometrioid EC with myometrial invasion >50% and non-endometrioid histology) EC patients undergoing SNM followed by back-up lymphadenectomy and SNM alone. Results: Chart of consecutive 196 patients were evaluated. The study population included 83 and 113 patients with endometrioid and non-endometrioid EC, respectively. SNM alone and SNM followed by back-up lymphadenectomy were performed in 50 and 146 patients, respectively. Among patients having SNM alone, 14 (28%) were diagnosed with nodal disease. In the group of patients undergoing SNM plus back-up lymphadenectomy 34 (23.2%) were diagnosed with nodal disease via SNM. Back-up lymphadenectomy identified 2 (1%) additional patients with nodal disease (in the para-aortic area). Back-up lymphadenectomy allowed to remove adjunctive positive nodes in 16 (11%) patients. After the adoption of propensity-matched algorithm, we observed that patients undergoing SNM plus back-up lymphadenectomy experienced similar disease-free survival (p = 0.416, log-rank test) and overall survival (p = 0.940, log-rank test) than patients undergoing SLN alone. Conclusions: Although the small sample size, and the retrospective study design this study highlighted that type of nodal assessment did not impact survival outcomes in high-risk EC. Theoretically, back-up lymphadenectomy would be useful in improving the removal of positive nodes, but its therapeutic value remains controversial. Further prospective evidence is needed.
Additional details
Identifiers
- URL
- https://hdl.handle.net/11567/1122075
- URN
- urn:oai:iris.unige.it:11567/1122075
Origin repository
- Origin repository
- UNIGE