A prospective multicenter trial on sentinel lymph node biopsy in patients with early-stage cervical cancer (SENTIX)

Cibula, David; Dušek, Jiří; Jarkovský, Jiří; Dundr, Pavel; Querleu, Denis; Zee, Ate van der; Kucukmetin, Ali; Kocián, Roman

doi:10.1136/ijgc-2018-000010

Cited by 70 publications

(45 citation statements)

References 16 publications

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“…This topic can be answered by currently ongoing prospective studies. 10,147,148 We believe that an ultrastaging protocol aimed at the detection of as many MICs and ITCs as possible should be favored over a more limited approach, until more data regarding their clinical significance are obtained. However, regarding the significance of ITCs, it would be difficult to gain data that would allow us to assess their prognostic meaning even from prospective trials.…”

Section: Discussionmentioning

confidence: 99%

Pathologic Protocols for Sentinel Lymph Nodes Ultrastaging in Cervical Cancer

Dundr

Cibula

Němejcová

et al. 2019

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Ultrastaging of sentinel lymph nodes (SLNs) is a crucial aspect in the approach to SLN processing. No consensual protocol for pathologic ultrastaging has been approved by international societies to date. Objective.— To provide a review of the ultrastaging protocol and all its aspects related to the processing of SLNs in patients with cervical cancer. Data Sources.— In total, 127 publications reporting data from 9085 cases were identified in the literature. In 24% of studies, the information about SLN processing is entirely missing. No ultrastaging protocol was used in 7% of publications. When described, the differences in all aspects of SLN processing among the studies and institutions are substantial. This includes grossing of the SLN, which is not completely sliced and processed in almost 20% of studies. The reported protocols varied in all aspects of SLN processing, including the thickness of slices (range, 1–5 mm), the number of levels (range, 0–cut out until no tissue left), distance between the levels (range, 40–1000 μm), and number of sections per level (range, 1–5). Conclusions.— We found substantial differences in protocols used for SLN pathologic ultrastaging, which can impact sensitivity for detection of micrometastases and even small macrometastases. Since the involvement of pelvic lymph nodes is the most important negative prognostic factor, such profound discrepancies influence the referral of patients to adjuvant radiotherapy and could potentially cause treatment failure. It is urgent that international societies agree on a consensual protocol before SLN biopsy without pelvic lymphadenectomy is introduced into routine clinical practice.

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Section: Discussionmentioning

confidence: 99%

Pathologic Protocols for Sentinel Lymph Nodes Ultrastaging in Cervical Cancer

Dundr

Cibula

Němejcová

et al. 2019

Archives of Pathology &Amp; Laboratory Medicine

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“…PI-88 is in clinical trial for the treatment of liver cancer, non-small cell lung cancer, melanoma, and prostate cancer (). Similarly, CX-01 is currently in clinical trials for myeloid leukaemia and cervical cancer [42]. Thus, it is clear that these HS mimetics have the potential to treat human disease and have been shown to produce very few side effects.…”

Section: Discussionmentioning

confidence: 99%

The Use of Myelinating Cultures as a Screen of Glycomolecules for CNS Repair

McCanney

Lindsay

McGrath

et al. 2019

Biology

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In vitro cell-based assays have been fundamental in modern drug discovery and have led to the identification of novel therapeutics. We have developed complex mixed central nervous system (CNS) cultures, which recapitulate the normal process of myelination over time and allow the study of several parameters associated with CNS damage, both during development and after injury or disease. In particular, they have been used as a reliable screen to identify drug candidates that may promote (re)myelination and/or neurite outgrowth. Previously, using these cultures, we demonstrated that a panel of low sulphated heparin mimetics, with structures similar to heparan sulphates (HSs), can reduce astrogliosis, and promote myelination and neurite outgrowth. HSs reside in either the extracellular matrix or on the surface of cells and are thought to modulate cell signaling by both sequestering ligands, and acting as co-factors in the formation of ligand-receptor complexes. In this study, we have used these cultures as a screen to address the repair potential of numerous other commercially available sulphated glycomolecules, namely heparosans, ulvans, and fucoidans. These compounds are all known to have certain characteristics that mimic cellular glycosaminoglycans, similar to heparin mimetics. We show that the N-sulphated heparosans promoted myelination. However, O-sulphated heparosans did not affect myelination but promoted neurite outgrowth, indicating the importance of structure in HS function. Moreover, neither highly sulphated ulvans nor fucoidans had any effect on remyelination but CX-01, a low sulphated porcine intestinal heparin, promoted remyelination in vitro. These data illustrate the use of myelinating cultures as a screen and demonstrate the potential of heparin mimetics as CNS therapeutics.

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“…In the latest FIGO staging system for cervical cancer, patients with lymphatic metastasis are classified as stage IIIC and should be treated with concurrent chemoradiotherapy [17]. The safety and benefits of omitting lymphadenectomy in SLN-negative patients remain to be determined in prospective trials (SENTIX = NCT02494063, CSEM010 = NCT02642471, SENTICOL III = NCT03386734) [18,19]. Yet, in many institutions, gynecologists have been accustomed to replacing lymphadenectomy with SLN biopsy and waiting for final pathology only.…”

Section: Discussionmentioning

confidence: 99%

Potential risks in sentinel lymph node biopsy for cervical cancer: a single-institution pilot study

Wan

Zhang

et al. 2020

World J Surg Onc

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Background: Sentinel lymph node (SLN) biopsy is an attractive technique that is widely performed in many oncological surgeries. However, the potential risks in SLN biopsy for cervical cancer remains largely unclear. Methods: Seventy-five patients with histologically confirmed cervical cancer were enrolled between May 2014 and June 2016. SLN biopsies were performed followed by pelvic lymphadenectomies and all resected nodes were labeled according to their anatomic areas. Only bilateral detections of SLNs were considered successful. Patients' clinicopathologic feature, performance of SLN detection, and distributions of lymph node metastases were analyzed. Results: Of the 75 enrolled patients, at least one SLN was detected in 69 (92.0%), including 33 in bilateral and 36 in unilateral. SLNs were most detected in the obturator area (52 of 69 patients, 75.4%) and 26 (37.7%) patients presented SLNs in more than one area of hemipelvis. Lymphovascular invasion was found to be the only factor that adversely influenced SLN detection, while the tumor diameter, growth type, histological grade, deep stromal invasion, and neoadjuvant chemotherapy showed no significant impacts. Patients with lymphovascular invasion showed a significantly higher rate to have unsuccessful detection (90.9% versus 41.5%, P < 0.001) and lymph node metastasis (40.9% versus 3.8%, P < 0.001) compared with those without. Nodal metastases were confirmed in 11 patients, of whom 9 (81.8%) had lymphovascular invasion and 7 (63.6%) had non-SLN metastasis. The most frequently involved SLNs were obturator nodes (9/11, 81.8%). In addition, the parametrial nodes also have a high rate to be positive (4/11, 36.4%), although they were relatively less identified as SLNs. Besides, 3 patients showed metastases in the laterals without SLN detected. Conclusions: In cervical cancer, lymphovascular invasion is a significant factor for unsuccessful SLN detection. The risk of having undetected metastasis is high when SLN is positive; therefore, further lymphadenectomy may be necessary for these patients.

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A prospective multicenter trial on sentinel lymph node biopsy in patients with early-stage cervical cancer (SENTIX)

Cited by 70 publications

References 16 publications

Pathologic Protocols for Sentinel Lymph Nodes Ultrastaging in Cervical Cancer

Pathologic Protocols for Sentinel Lymph Nodes Ultrastaging in Cervical Cancer

The Use of Myelinating Cultures as a Screen of Glycomolecules for CNS Repair

Potential risks in sentinel lymph node biopsy for cervical cancer: a single-institution pilot study

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