Emilie Raimond1, Marcos Ballester2, Delphine Hudry3, Sofiane Bendifallah2, Emile Daraï2, Olivier Graesslin4, Charles Coutant3. 1. Department of Obstetrics and Gynecology, Maison Blanche Hospital, Reims-Champagne-Ardennes University, Reims, France. Electronic address: Emilie_raimond@hotmail.com. 2. Department of Obstetrics and Gynecology, Tenon Hospital, AP-HP, Pierre et Marie Curie University - Paris 6, Paris, France. 3. Department of Surgical Oncology, Georges-François Leclerc Cancer Center, Bourgogne University, Dijon, France. 4. Department of Obstetrics and Gynecology, Maison Blanche Hospital, Reims-Champagne-Ardennes University, Reims, France.
Abstract
OBJECTIVE: The aim of this study is to assess the impact of sentinel lymph node (SLN) mapping and ultrastaging on the therapeutic management of early-stage endometrial cancer. METHODS: This retrospective multicenter study covered the period from January 2000 through December 2012 and included 304 women with presumed low- or intermediate-risk endometrial cancer. Node staging, histology results, and the effects of both on therapeutic management were assessed in two groups: those who underwent the SLN mapping and ultrastaging procedure and those treated in accordance with French guidelines. RESULTS: The SLN procedure detected metastatic lymph nodes in three times more women than lymphadenectomy did (16.2% versus 5.1%, p=0.03). Specifically, it found 7 macrometastases (5.1%) and 15 micrometastases (11%); 11 of the latter (8.1%) were detected by serial sectioning and immunohistochemistry (IHC), that is, pathologic ultrastaging. The SLN biopsy false-negative rate was 0% (95% CI: 0-1.6%). This ultrastaging enabled us to modify the adjuvant therapy for half the patients. Women with micrometastases detected by the SLN procedure were treated with external beam radiotherapy (EBRT), while those whose SLN biopsies were negative received vaginal brachytherapy (VBT) or clinical follow-up. SLN biopsies had no impact on recurrence-free survival. CONCLUSION: SLN mapping and ultrastaging improved staging and made it possible to adapt adjuvant therapy to risk of recurrence.
OBJECTIVE: The aim of this study is to assess the impact of sentinel lymph node (SLN) mapping and ultrastaging on the therapeutic management of early-stage endometrial cancer. METHODS: This retrospective multicenter study covered the period from January 2000 through December 2012 and included 304 women with presumed low- or intermediate-risk endometrial cancer. Node staging, histology results, and the effects of both on therapeutic management were assessed in two groups: those who underwent the SLN mapping and ultrastaging procedure and those treated in accordance with French guidelines. RESULTS: The SLN procedure detected metastatic lymph nodes in three times more women than lymphadenectomy did (16.2% versus 5.1%, p=0.03). Specifically, it found 7 macrometastases (5.1%) and 15 micrometastases (11%); 11 of the latter (8.1%) were detected by serial sectioning and immunohistochemistry (IHC), that is, pathologic ultrastaging. The SLN biopsy false-negative rate was 0% (95% CI: 0-1.6%). This ultrastaging enabled us to modify the adjuvant therapy for half the patients. Women with micrometastases detected by the SLN procedure were treated with external beam radiotherapy (EBRT), while those whose SLN biopsies were negative received vaginal brachytherapy (VBT) or clinical follow-up. SLN biopsies had no impact on recurrence-free survival. CONCLUSION: SLN mapping and ultrastaging improved staging and made it possible to adapt adjuvant therapy to risk of recurrence.
Authors: Robert W Holloway; Nadeem R Abu-Rustum; Floor J Backes; John F Boggess; Walter H Gotlieb; W Jeffrey Lowery; Emma C Rossi; Edward J Tanner; Rebecca J Wolsky Journal: Gynecol Oncol Date: 2017-05-28 Impact factor: 5.482
Authors: F J Backes; A S Felix; M Plante; J Grégoire; S A Sullivan; E C Rossi; E J Tanner; K I Stewart; P T Soliman; R W Holloway; N R Abu-Rustum; M M Leitao Journal: Gynecol Oncol Date: 2021-03-05 Impact factor: 5.304
Authors: Dib Sassine; Sara Moufarrij; Anjelica Hodgson; Sarah Ehmann; Nadeem R Abu-Rustum; Sarah Chiang; Elizabeth L Jewell Journal: Gynecol Oncol Rep Date: 2021-04-30