Lucia Tortorella1, Jvan Casarin2, Francesco Multinu2, Serena Cappuccio2, Michaela E McGree3, Amy L Weaver3, Carrie L Langstraat2, Gary L Keeney4, Amanika Kumar2, Gian Benedetto Melis5, Stefano Angioni5, Giovanni Scambia6, Andrea Mariani2, Gretchen E Glaser7. 1. Division of Gynecologic Oncology, Mayo Clinic, Rochester, MN, United States of America; Department of Obstetrics and Gynecology, Fondazione Policlinico Universitario A. Gemelli, IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy. 2. Division of Gynecologic Oncology, Mayo Clinic, Rochester, MN, United States of America. 3. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, United States of America. 4. Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, United States of America. 5. Division of Gynecology and Obstetrics, University of Cagliari, Cagliari, Italy. 6. Department of Obstetrics and Gynecology, Fondazione Policlinico Universitario A. Gemelli, IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy. 7. Division of Gynecologic Oncology, Mayo Clinic, Rochester, MN, United States of America. Electronic address: glaser.gretchen@mayo.edu.
Abstract
OBJECTIVE: To identify predictors of unsuccessful sentinel lymph node (SLN) mapping in patients with apparent early-stage endometrial cancer (EC) undergoing surgical staging with cervical injection of indocyanine green and SLN biopsy. METHODS: We retrospectively identified consecutive patients with EC with attempted SLN biopsy between June 2014 and June 2016 at our institution. Patients were grouped according to whether they had a successful procedure, defined as the bilateral identification of SLNs, or an unsuccessful procedure, defined as unilateral or no SLN mapping. Logistic regression was used to evaluate predictors of an unsuccessful procedure. RESULTS: Among 327 patients included in the analysis, 256 (78.3%) had a successful procedure and 71 (21.7%) had an unsuccessful procedure (15.0% unilateral SLN mapping, 6.7% no mapping). The rate of successful procedure increased from 57.7% to 83.3% between the first and last quarters of the 2-year study period, which represented the learning curve for the technique. The mean (SD) operative time decreased from 164 (55) to 137 (37) minutes. By multivariable analysis, lysis of adhesions at the beginning of surgery (odds ratio, 3.07; 95% CI, 1.56-6.07) and the presence of enlarged lymph nodes (odds ratio, 4.69; 95% CI, 1.82-12.11) were independently associated with an unsuccessful procedure. CONCLUSIONS: Lysis of adhesions at the beginning of surgery and the presence of enlarged lymph nodes independently affect the bilateral detection of SLNs.
OBJECTIVE: To identify predictors of unsuccessful sentinel lymph node (SLN) mapping in patients with apparent early-stage endometrial cancer (EC) undergoing surgical staging with cervical injection of indocyanine green and SLN biopsy. METHODS: We retrospectively identified consecutive patients with EC with attempted SLN biopsy between June 2014 and June 2016 at our institution. Patients were grouped according to whether they had a successful procedure, defined as the bilateral identification of SLNs, or an unsuccessful procedure, defined as unilateral or no SLN mapping. Logistic regression was used to evaluate predictors of an unsuccessful procedure. RESULTS: Among 327 patients included in the analysis, 256 (78.3%) had a successful procedure and 71 (21.7%) had an unsuccessful procedure (15.0% unilateral SLN mapping, 6.7% no mapping). The rate of successful procedure increased from 57.7% to 83.3% between the first and last quarters of the 2-year study period, which represented the learning curve for the technique. The mean (SD) operative time decreased from 164 (55) to 137 (37) minutes. By multivariable analysis, lysis of adhesions at the beginning of surgery (odds ratio, 3.07; 95% CI, 1.56-6.07) and the presence of enlarged lymph nodes (odds ratio, 4.69; 95% CI, 1.82-12.11) were independently associated with an unsuccessful procedure. CONCLUSIONS: Lysis of adhesions at the beginning of surgery and the presence of enlarged lymph nodes independently affect the bilateral detection of SLNs.
Authors: N Bizzarri; S Restaino; S Gueli Alletti; G Monterossi; A Gioè; E La Fera; V Gallotta; A Fagotti; G Scambia; F Fanfani Journal: Facts Views Vis Obgyn Date: 2021-03-31
Authors: Tilman T Rau; Mona V Deppeler; Lucine Christe; Franziska Siegenthaler; Sara Imboden; Andrea Papadia; Michael D Mueller Journal: Virchows Arch Date: 2022-07-19 Impact factor: 4.535
Authors: Alison A Garrett; Alyssa Wield; Brigid Mumford; Isabel Janmey; Li Wang; Philip Grosse; Emily MacArthur; Ronald Buckanovich; Madeleine Courtney-Brooks; Paniti Sukumvanich; Jessica Berger; Alexander B Olawaiye; Haider Mahdi; Michelle Boisen; Robert P Edwards; Lan Coffman; Sarah E Taylor; Jamie Lesnock Journal: Gynecol Oncol Rep Date: 2022-10-07