Can risk groups accurately predict non‐sentinel lymph node metastasis in sentinel lymph node‐positive endometrial cancer patients? A Turkish Gynecologic Oncology Group Study (TRSGO‐SLN‐004)

Altın, Duygu; Taşkın, Salih; Tokgözoğlu, Nedim; Vatansever, Doğan; Güler, Abdül Hamid; Güngör, Mete; Taşçı, Tolga; Turan, Hasan; Kahramanoğlu, İlker; Yalçın, İbrahim; Çelık, Çetin; Köse, Faruk; Ortaç, Fırat; Arvas, Macit; Ayhan, Ali; Taşkiran, Ç.

doi:10.1002/jso.26310

Cited by 5 publications

(4 citation statements)

References 29 publications

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“…Retrospective data have reported an incidence of 35% to 40% of non-SLN metastasis ( 64 , 138 ). The risk of non-SLN metastasis is associated with the size of SLN metastasis and uterine higher-risk factors ( 160 ). Touhami et al ( 138 ) found out that 60.8% of non-SLNs were positive when SLN was found to harbor macro-metastases.…”

Section: Controversial Issuesmentioning

confidence: 99%

Sentinel Lymph Node Mapping in Endometrial Cancer: A Comprehensive Review

et al. 2021

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Endometrial cancer (EC) is known as a common gynecological malignancy. The incidence rate is on the increase annually. Lymph node status plays a crucial role in evaluating the prognosis and selecting adjuvant therapy. Currently, the patients with high-risk (not comply with any of the following: (1) well-differentiated or moderately differentiated, pathological grade G1 or G2; (2) myometrial invasion< 1/2; (3) tumor diameter < 2 cm are commonly recommended for a systematic lymphadenectomy (LAD). However, conventional LAD shows high complication incidence and uncertain survival benefits. Sentinel lymph node (SLN) refers to the first lymph node that is passed by the lymphatic metastasis of the primary malignant tumor through the regional lymphatic drainage pathway and can indicate the involvement of lymph nodes across the drainage area. Mounting evidence has demonstrated a high detection rate (DR), sensitivity, and negative predictive value (NPV) in patients with early-stage lower risk EC using sentinel lymph node mapping (SLNM) with pathologic ultra-staging. Meanwhile, SLNM did not compromise the patient’s progression-free survival (PFS) and overall survival (OS) with low operative complications. However, the application of SLNM in early-stage high-risk EC patients remains controversial. As revealed by the recent studies, SLNM may also be feasible, effective, and safe in high-risk patients. This review aims at making a systematic description of the progress made in the application of SLNM in the treatment of EC and the relevant controversies, including the application of SLNM in high-risk patients.

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Section: Controversial Issuesmentioning

confidence: 99%

Sentinel Lymph Node Mapping in Endometrial Cancer: A Comprehensive Review

et al. 2021

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“…The second major challenge when preforming SLNB is the risk of possible residual metastasis to non-SLN. The risk is associated with the size of the SLN metastasis and uterine higher-risk factors ( 111 ). Therefore, it is of high importance to carefully follow the SLNB algorithm and always remove any suspicious enlarged lymph nodes.…”

Section: Lymph Nose Assessmentmentioning

confidence: 99%

Recent management of endometrial cancer: a narrative review of the literature

Pados,

Zouzoulas,

Tsolakidis

2024

Front. Med.

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Endometrial cancer is a common female gynecological neoplasia and its incidence rate has increased in the past years. Due to its predominant symptoms, most women will present uterine bleeding. It is usually diagnosed at an early stage and surgery has an important role in the treatment plan. The prognosis and quality of life of these patients can be quite favorable, if proper treatment is offered by surgeons. Traditionally, more invasive approaches and procedures were offered to these patients, but recent data suggest that more conservative and minimal invasive choices can be adopted in the treatment algorithm. Minimal invasive surgery, such as laparoscopy and robotic surgery, should be considered as an acceptable alternative, compared to laparotomy with less comorbidities and similar oncological and survival outcomes. Furthermore, sentinel lymph node biopsy has emerged in the surgical staging of endometrial cancer, in order to replace comprehensive lymphadenectomy. It is associated with less intra- and postoperative complications, while preliminary data show no difference in survival rates. However, sentinel lymph node biopsy should be offered within a strict algorithm, to avoid residual metastatic disease. The aim of this review is to analyze all the available data for the application of minimal invasive surgery in early endometrial cancer and especially the role of sentinel lymph node biopsy.

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“…Metastasis in non-SLNs can occur up to 30–40% [ 81 , 82 , 83 ]. In theory, if non-SLNs are not sampled, occult nodal metastasis may be missed, which may lead to down-staging of the disease and omitting the use of adjuvant therapy which may otherwise be indicated.…”

Section: Management Of Sln- and Non-sln Metastasismentioning

confidence: 99%

“…Multivariate analysis showed that size of SLN metastasis >2 mm was the only predictive factor for non-SLN metastasis (5% vs 60.8%; p < 0.0001), while histological type and grade, myometrial invasion, LVSI and cervical stromal invasion were not significant. Altin et al analyzed 395 patients who had either SLNB or at least pelvic LND [ 83 ]. Among those 42 patients who had SLN metastasis, 16 patients had non-SLN metastasis.…”

Section: Management Of Sln- and Non-sln Metastasismentioning

confidence: 99%

Applications and Safety of Sentinel Lymph Node Biopsy in Endometrial Cancer

Chiu

Kwok

Wang

et al. 2022

JCM

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Lymph node status is important in predicting the prognosis and guiding adjuvant treatment in endometrial cancer. However, previous studies showed that systematic lymphadenectomy conferred no therapeutic values in clinically early-stage endometrial cancer but might lead to substantial morbidity and impact on the quality of life of the patients. The sentinel lymph node is the first lymph node that tumor cells drain to, and sentinel lymph node biopsy has emerged as an acceptable alternative to full lymphadenectomy in both low-risk and high-risk endometrial cancer. Evidence has demonstrated a high detection rate, sensitivity and negative predictive value of sentinel lymph node biopsy. It can also reduce surgical morbidity and improve the detection of lymph node metastases compared with systematic lymphadenectomy. This review summarizes the current techniques of sentinel lymph node mapping, the applications and oncological outcomes of sentinel lymph node biopsy in low-risk and high-risk endometrial cancer, and the management of isolated tumor cells in sentinel lymph nodes. We also illustrate a revised sentinel lymph node biopsy algorithm and advocate to repeat the tracer injection and explore the presacral and paraaortic areas if sentinel lymph nodes are not found in the hemipelvis.

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Can risk groups accurately predict non‐sentinel lymph node metastasis in sentinel lymph node‐positive endometrial cancer patients? A Turkish Gynecologic Oncology Group Study (TRSGO‐SLN‐004)

Cited by 5 publications

References 29 publications

Sentinel Lymph Node Mapping in Endometrial Cancer: A Comprehensive Review

Sentinel Lymph Node Mapping in Endometrial Cancer: A Comprehensive Review

Recent management of endometrial cancer: a narrative review of the literature

Applications and Safety of Sentinel Lymph Node Biopsy in Endometrial Cancer

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