Sentinel lymph node mapping and staging in endometrial cancer: A Society of Gynecologic Oncology literature review with consensus recommendations

Holloway, Robert W.; Abu‐Rustum, Nadeem R.; Backes, Floor J.; Boggess, John F.; Gotlieb, Walter H.; Lowery, William J.; Rossi, Emma; Tanner, Edward J.; Wolsky, Rebecca J.

doi:10.1016/j.ygyno.2017.05.027

Cited by 322 publications

(313 citation statements)

References 92 publications

(141 reference statements)

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“…The bilateral detection rate, which is reported between 6 and 88% with a pooled average of 50%, is much more variable [22][23][24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Sentinel Lymph Node Biopsy in the Treatment of Endometrial Cancer: Why We Fail? Results of a Prospective Multicenter Study on the Factors Associated with Failure of Node Mapping with Indocyanine Green

Ianieri

Puppo²,

Novelli³

et al. 2019

Gynecol Obstet Invest

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Background: The sentinel lymph node (SLN) mapping for endometrial cancer staging is gaining wide diffusion, but there is no definitive evidence on the factors associated with the failure of mapping. Objectives: To analyze the factors associated with the possible failure of bilateral SLN mapping with indocyanine green (ICG). Methods: A prospective observational study without control on 110 patients with endometrial cancer apparently confined to the uterus, underwent laparoscopic surgical staging with SLN mapping with ICG. Results: Possible risk factors associated with bilateral mapping failure were analyzed, and a multivariate analysis was performed. The bilateral detection rate for SLNs mapping was 72.7%, whereas at least one SLN was detected in 79.1% of patients. No SLNs were identified in 6.3%. None of the patients or features related to tumor were associated with a risk of failure of the method. The only factor analyzed that was significantly associated with the success of bilateral mapping was the surgeon (p = 0.003). Conclusions: Neither obesity nor the presence of lymph node metastases was associated with mapping failure. However, there remains a need for further studies to understand all the mechanisms linked to the unsuccessful method results and to reduce the use of systematic lymphadenectomy in the case of mapping failure.

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“…The bilateral detection rate, which is reported between 6 and 88% with a pooled average of 50%, is much more variable [22][23][24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Sentinel Lymph Node Biopsy in the Treatment of Endometrial Cancer: Why We Fail? Results of a Prospective Multicenter Study on the Factors Associated with Failure of Node Mapping with Indocyanine Green

Ianieri

Puppo²,

Novelli³

et al. 2019

Gynecol Obstet Invest

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“…Detection of a sentinel lymph node in EC patients is not a standardised process yet. There are several methods of detection that differ according to the site of application and the combination of tracers . In our study, the method of intracervical application was used.…”

Section: Discussionmentioning

confidence: 99%

One‐step nucleic acid amplification vs ultrastaging in the detection of sentinel lymph node metastasis in endometrial cancer patients

Kosťun

Pešta

Sláma

et al. 2018

Journal of Surgical Oncology

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Background and Objectives Utilisation of the one‐step nucleic acid amplification (OSNA) molecular biology method for the detection of the metastatic involvement of sentinel lymph nodes (SLNs) in endometrial cancer (EC) patients. A comparison with histopathological ultrastaging and a description of the clinical consequences. Methods Surgically treated EC patients underwent detection of SLNs. Nodes greater than 5 mm were cut into sections 2‐mm thick parallel to the short axis of the node. Odd sections were examined according to the OSNA method, while even ones according to an appropriate ultrastaging protocol. Nodes less than or equal to 5 mm were cut into halves along the longitudinal axis with one half examined according to the OSNA method and the other half by ultrastaging. Results Fifty‐eight patients were included and 135 SLNs were acquired. Both ultrastaging and OSNA agreed on 116 results. According to the OSNA method, 20.69% more patients were classified into International Federation of Gynecology and Obstetrics (FIGO) stage III. When comparing the results of the OSNA method to the conclusions of ultrastaging as a reference method, sensitivity of 90.9%, specificity of 85.5% and concordance of 85.9% were attained. Conclusions The results of the OSNA method showed a higher frequency of detection of micrometastases and included 20.69% more patients into FIGO stage III.

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Section: Resultsmentioning

confidence: 99%

“…SLNM can be used for surgical lymph node staging in early tumors and has a lower morbidity rate than systematic lymphadenectomy . Among the SLNM methods, indocyanine green (ICG) fluorescence has the highest accuracy . A meta‐analysis of 55 studies and 4915 patients found that the rate of SLN detection with SLNM was 81% (95% confidence interval, 77‐84) vs 50% for bilateral detection (95% confidence interval, 44‐56).…”

Section: Resultsmentioning

confidence: 99%

Brazilian Society of Surgical Oncology guidelines for surgical treatment of endometrial cancer in regions with limited resources

Ribeiro

Cintra

Barrozo

et al. 2019

Journal of Surgical Oncology

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Background Approximately 70% of cancer‐related deaths occur in low‐ and middle‐income countries. In addition to social and racial inequalities, treatment options in these countries are usually limited because of the lack of trained staff and equipment, limited patient access to health services, and a small number of clinical guidelines. Objectives The Brazilian Society of Surgical Oncology developed this guideline to address these barriers and guide physicians treating patients with endometrial cancer (EC) in regions with limited resources and few specialized centers. Methods The guideline was prepared from 10 January to 25 October 20192019 by a multidisciplinary team of 56 experts to discuss the main obstacles faced by EC patients in Brazil. Thirteen questions considered critical to the surgical treatment of these patients were defined. The questions were assigned to groups that reviewed the literature and drafted preliminary recommendations. Following a review by the coordinators and a second review by all participants, the groups made final adjustments for presentations in meetings, classified the level of evidence, and voted on the recommendations. Results For all questions including staging, fertility spearing treatment, genetic testing, sentinel lymph node use, surgical treatment, and other clinical relevant questions, major agreement was achieved by the participants, always using accessible alternatives. Conclusions It is possible to provide adequate treatment for most EC patients in resource‐limited areas, but the first option should be referral to specialized centers with more resources.

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Sentinel lymph node mapping and staging in endometrial cancer: A Society of Gynecologic Oncology literature review with consensus recommendations

Cited by 322 publications

References 92 publications

Sentinel Lymph Node Biopsy in the Treatment of Endometrial Cancer: Why We Fail? Results of a Prospective Multicenter Study on the Factors Associated with Failure of Node Mapping with Indocyanine Green

Sentinel Lymph Node Biopsy in the Treatment of Endometrial Cancer: Why We Fail? Results of a Prospective Multicenter Study on the Factors Associated with Failure of Node Mapping with Indocyanine Green

One‐step nucleic acid amplification vs ultrastaging in the detection of sentinel lymph node metastasis in endometrial cancer patients

Brazilian Society of Surgical Oncology guidelines for surgical treatment of endometrial cancer in regions with limited resources

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