Sentinel lymph node (SLN) isolated tumor cells (ITCs) in otherwise stage I/II endometrioid endometrial cancer: To treat or not to treat?

Backes, Floor J.; Felix, Ashley S.; Plante, Marie; Grégoire, Jean; Sullivan, Stephanie A.; Rossi, Emma; Tanner, Edward J.; Stewart, K.I.; Soliman, Pamela T.; Holloway, Robert W.; Abu‐Rustum, Nadeem R.; Leitao, Mario M.

doi:10.1016/j.ygyno.2021.02.017

Cited by 32 publications

(46 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The sentinel node detection was another promising method for identifying LNM in OC patients. The sentinel node detection is still under evaluation in OC patients before it was as part of the standard therapeutic protocol, despite the method using for breast cancer and cervical cancer [7,18,19,20]. Bogani et al developed a nomogram to identify LNM and found that high-grade serous histology was a strongest predictor for LNM [5,21].…”

Section: Discussionmentioning

confidence: 99%

A Novel Clinical Nomogram for Predicting Lymph Node Metastasis in Ovarian Cancer: A SEER Analysis and External Validation in a Tertiary Center

Zhang¹,

Ren²

2021

Preprint

View full text Add to dashboard Cite

Introduction The aim of the study is to investigate the risk factors for developing lymph node metastases (LNM) in cases diagnosed as a presumed early-stage ovarian carcinoma (OC). Methodology Information of patients who had been diagnosed as OC in 2018 was obtained from the SEER database. We enrolled 104 OC patients in General Hospital of Northern Theatre Command for external validation. A logistic regression was conducted to determine the independent predictors for LNM, which were used for establishing a nomogram. In order to evaluate the reliability of nomogram, we applied a receiver operating characteristic curve (ROC) analysis, calibration curves and plotted decision curves. Results We found that age(≥70, OR=0.544, p=0.022), histology type (Mucinous carcinoma, OR=0.390, p=0.001; Endometrioid carcinoma, OR=7.946, p=0.053; Others, OR=2.400, p=0.040), histology grade (Grade II, OR=2.423, p=0.028; Grade III, OR=1.982, p=0.152; Grade IV, OR=1.594, p=0.063) and preoperative serum CA125 level (positive, OR=2.236, p=0.001) were all significant predictors of LNM. The AUC of the model training cohort, internal validation cohort, and external validation cohort were 0.78, 0.79 and 0.76 respectively. The calibration curves showed that the predicted outcome fitted well to the observed outcome in the training cohort (p=0.825) internal validation cohort (p=0.503), and external validation cohort (p=0.108). The decision curves showed the nomogram had more benefits than the All or None scheme if the threshold probability is >50% and <100% in training cohort and internal validation cohort, >30% and <90% in the external validation cohort. Conclusion The multivariate logistic regression showed that age, histology type, histology grade and preoperative serum CA125 level were all significant predictors of LNM. The nomogram established using the above variables had great performance for clinical applying.

show abstract

Section: Discussionmentioning

confidence: 99%

A Novel Clinical Nomogram for Predicting Lymph Node Metastasis in Ovarian Cancer: A SEER Analysis and External Validation in a Tertiary Center

Zhang¹,

Ren²

2021

Preprint

View full text Add to dashboard Cite

show abstract

“…The authors observed that the omission of adjuvant therapy was not impacting progression-free survival in endometroid endometrial cancer with isolated tumor cells. Interestingly, this study highlighted that the type of nodal dissection (i.e., sentinel node mapping plus backup lymphadenectomy vs. sentinel node mapping alone) does not impact patients' outcomes [28]. Similarly, Ghoniem et al, collected data of 247 patients with endometrial cancer and low volume disease [29].…”

Section: Role Of Adjuvant Therapy For Low Volume Diseasementioning

confidence: 91%

“…Nodal recurrence rates were 4.7% in patients with micrometastasis and 0% in patients with isolated tumor cells [27]. Recently, two multi-institutional retrospective experiences reported data regarding the role of adjuvant therapy in patients with low-volume disease [28,29]. Backes et al, recorded data of 175 patients with endometroid endometrial cancer with isolated tumor cells harboring in the sentinel nodes.…”

Section: Role Of Adjuvant Therapy For Low Volume Diseasementioning

confidence: 99%

“…As surrogate markers of the TCGA classification, the Proactive Molecular Risk Classifier for Endometrial Cancer (ProMisE) categorized endometrial cancers into four prognostic molecular subgroups POLE mutated/ultramutated (POLE mut), microsatelliteunstable/hypermutated (MSI or mismatch repair deficient (MMRd)), copy-number-low/TP53-wild-type (CNL/NSMP), and copy-numberhigh/TP53-abnormal (CNH/p53 abn) [30]. Accumulating data highlighted the importance of adopting molecular classification [28,29,31,32]. The ESGO/ESTRO/ESP guidelines supported the adoption of genomic/molecular profiling in selecting patients for having post-surgical treatments [2].…”

Section: Low Volume Disease In the Era Of Molecular/genomic Profilingmentioning

confidence: 99%

See 1 more Smart Citation

Assessing the role of low volume disease in endometrial cancer

Bogani

Palaia

Perniola

et al. 2022

European Journal of Obstetrics & Gynecology and Reproductiv

View full text Add to dashboard Cite

“…She had a pelvic node, a para-aortic node, and an adnexal metastasis, but all metastatic diseases were micrometastasis (<2 mm). Similarly, isolated tumor cells detected in removed sentinel nodes may not decrease survival, even without adjuvant therapy [ 123 , 124 , 125 , 126 ].…”

Section: Benefit Of Systematic Lymphadenectomy In Node-negative Patie...mentioning

confidence: 99%

Therapeutic Benefit of Systematic Lymphadenectomy in Node-Negative Uterine-Confined Endometrioid Endometrial Carcinoma: Omission of Adjuvant Therapy

Otsuka

2022

Cancers

View full text Add to dashboard Cite

Endometrial cancer is the most common gynecological tract malignancy in developed countries, and its incidence has been increasing globally with rising obesity rates and longer life expectancy. In endometrial cancer, extrauterine disease, in particular lymph node metastasis, is an important prognostic factor. Nevertheless, pelvic lymphadenectomy is not considered to have a therapeutic benefit, as it did not improve survival in randomized studies. However, lymphadenectomy may have a therapeutic benefit if adjuvant therapy can be omitted without decreasing oncological outcomes, as the long-term quality of life is maintained by avoiding morbidities associated with adjuvant therapy. In intermediate- and high-risk endometrioid endometrial carcinomas, adjuvant therapy may be safely omitted without decreasing long-term survival by open surgery including systematic pelvic and para-aortic lymphadenectomy when patients are node-negative. Systematic lymphadenectomy may remove undetectable low-volume lymph node metastasis in both pelvic and para-aortic regions, and open surgery may reduce vaginal recurrence even without vaginal brachytherapy. However, lymphadenectomy may not improve survival in elderly patients and patients with p53-mutant tumors. In this review, I discuss the characteristics of lymph node metastasis, the methods of lymph node assessment, and the therapeutic benefits of systematic lymphadenectomy in patients with intermediate- and high-risk endometrioid endometrial carcinoma.

show abstract

Sentinel lymph node (SLN) isolated tumor cells (ITCs) in otherwise stage I/II endometrioid endometrial cancer: To treat or not to treat?

Cited by 32 publications

References 24 publications

A Novel Clinical Nomogram for Predicting Lymph Node Metastasis in Ovarian Cancer: A SEER Analysis and External Validation in a Tertiary Center

A Novel Clinical Nomogram for Predicting Lymph Node Metastasis in Ovarian Cancer: A SEER Analysis and External Validation in a Tertiary Center

Assessing the role of low volume disease in endometrial cancer

Therapeutic Benefit of Systematic Lymphadenectomy in Node-Negative Uterine-Confined Endometrioid Endometrial Carcinoma: Omission of Adjuvant Therapy

Contact Info

Product

Resources

About