Stratégies ganglionnaires dans les cancers de l’endomètre

Owen, Cathy; Bendifallah, Sofiane; Jayot, Aude; Ilenko, Anna; Arfi, Alexandra; Richard, Sandrine; Varinot, Justine; Thomassin‐Naggara, Isabelle; Bazot, M; Daraı̈, Émile

doi:10.1016/j.bulcan.2019.06.015

Cited by 5 publications

(2 citation statements)

References 62 publications

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“…Endometrial carcinoma with lymphovascular space involvement (LVSI), myometrial invasion, lymph node (LN) metastasis, and high-grade cancer were associated with significantly higher recurrence rates (5). Accumulated studies have shown that LN metastasis is a strong independent prognostic factor for endometrial carcinoma recurrence (6,7). Recent studies revealed that LVSI is an independent prognostic factor for lymph node metastasis and non-locoregional recurrence in early-stage endometrial carcinoma (8,9).…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of Immune Microenvironment and Signaling Pathways in Endometrioid Endometrial Adenocarcinoma During Formation of Lymphovascular Space Involvement and Lymph Node Metastasis

et al. 2020

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BackgroundThe amplification or mutation of oncogenes and escape from immune surveillance systems promote tumor metastasis. However, subtle changes in the immune microenvironment and signaling pathways are poorly understood during the formation of lymphovascular space involvement (LVSI) and lymph node (LN) metastasis of endometrioid endometrial adenocarcinoma (EEA).Patients and methodsWe detected tumor immunology-related signaling pathways and immunocyte subtypes according to the mRNA levels of 750 oncogenes and genes relating to the tumor microenvironment and immune response using the Nanostring PanCancer IO 360 Panel in 24 paraffin-embedded tissues of EEAs and benign gynecological diseases. Internal reference genes were used for data normalization.ResultsAngiogenesis and immune cell adhesion signaling pathways were activated during LVSI formation of EEA progression. However, during the development of LVSI to LN metastasis, immune system signaling pathways were significantly inhibited, including antigen presentation, cytotoxicity, lymphoid compartment, interferon signaling, and costimulatory signaling pathways. Immune-related genes (CD69, HLA-DOA, ATF3, GBP1, AP2, DTX3L, EGR1, GBP4, TAP1, EIF2AK2, MX1, ISG15, STAT1, and HLA-DRA) were significantly downregulated in EEA with LN metastasis compared to those in EEA with LVSI. Instead, hypoxia, metabolic stress, epigenetic regulation, matrix remodeling, and metastasis signaling pathways were continuously activated in LN metastasis. We also found that neutrophils, macrophages, and mast cells might be involved in LVSI formation and LN metastasis in EEA.ConclusionsEEA with metastatic LNs showed significant immunosuppressive effects. Some oncogenes, matrix remodeling- and hypoxia-related genes, and neutrophil signatures showed higher expression, suggesting their potential as therapeutic targets and offering new immunotherapy strategies in EEA during LN metastasis.

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Section: Introductionmentioning

confidence: 99%

Reconstruction of Immune Microenvironment and Signaling Pathways in Endometrioid Endometrial Adenocarcinoma During Formation of Lymphovascular Space Involvement and Lymph Node Metastasis

et al. 2020

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“…In a similar study, Lurain et al calculated the survival rate as 54% in patients with lymph node metastases and 90% in patients without metastasis. In addition, disease recurrence was also examined and the frequency of recurrence increased from 8% in the case of negative lymph nodes to 48% in the case of positive lymph nodes [7][8][9].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Inferior Mesenteric Superior Lymph Node Metastasis in Early-Stage Endometrium Cancer and Its Clinical Significance

COMERT

2021

Am J Med Clin Sci

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Endometrial cancer is the fourth most common type of cancer in women cancers. In the light of projections, approximately 11,000 deaths occur annually in the USA alone. Lymph node metastasis is the most important prognostic factor in endometrial cancer. The aim of this study is to investigate the clinical and histopathological risk factors affecting lymph ode involvement. The study included 30 randomly selected women from external centers who applied to our clinic with a preliminary diagnosis of endometrial cancer and were diagnosed with endometrial cancer in our clinic. The study group was divided into two groups as stage I (early stage) and stage II and above (advanced stage) according to the stages. Total abdominal hysterectomy (Type II), bilateral salpingo-oophorectomy, paraaortic lymph node dissection from the pelvic and IMA to the level of the left renal vein, omentectomy, and peritoneal cytology sampling were performed on each of the endometrial cancer participants. The mean number of lymph node involvement in 30 patients in the study group was 45.9±15.1. The mean number of pelvic lymph nodes involved was 32.1±10.1, while the mean number of paraaortic lymph nodes involved was 13.9±6.9. As a result of the examinations, the highest number of Stage Ia was found. The frequency of endometrial adenocarcinoma was 80% and it was seen in 24 people. The mean tumor size, myometrial thickness, and depth of invasion of the patients were 2.97(±1.6), 1.57(±0.6), and 0.7(±0.6), respectively. With positive sub-IMA lymph node involvement, lymph node positivity was also detected in the area extending from the IMA to the level of the renal vein. It has been shown that the non-endomethroid tumor type detected in this group, myometrial invasion of more than 50%, grade 3 tumor and the presence of lymphovascular invasion affect lymph node involvement above the IMA.

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Évaluation de l’application des recommandations des cancers de l’endomètre de type 2 : étude rétrospective multicentrique

et al. 2020

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Introduction Les carcinomes de l’endomètre de type 2 sont des cancers peu fréquents et de mauvais pronostique. Il existe très peu d’étude analysant leur prise en charge. L’objectif de l’étude était d’étudier la prise en charge des carcinomes de type 2 dans nos centres en évaluant l’application des recommandations. Matériel et méthode Il s’agit d’une étude multicentrique rétrospective enregistrant les cancers de l’endomètre de type 2 pris en charge de janvier 2009 à décembre 2019. Les analyses ont été adaptées aux dernières recommandations françaises appliquées par rapport à l’année de prise en charge. Résultats Soixante-quatorze carcinomes de type 2 ont été analysés dans dix centres: 34 carcinosarcomes (45,9 %), 29 carcinomes séreux (39,2 %), neuf carcinomes à cellules claires (12,2 %) et deux carcinomes indifférenciés (2,7 %). Lors de la prise en charge initiale, les recommandations étaient appliquées dans 45,9 % des cas. Le principal motif de non-application des recommandations était la non-réalisation d’une stadification ganglionnaire chirurgicale pour 20 patientes (57,1 %). Lors de la prise en charge adjuvante, les recommandations étaient appliquées dans 37,8 % des cas. Le principal motif de non-application des recommandations était la non-réalisation d’une restadification ganglionnaire chirurgicale ou radiologique pour 25 patientes (67,6 %). Discussion L’applicabilité des recommandations pour la prise en charge des carcinomes de type 2 reste difficile en raison de l’âge élevé et des comorbidités des patientes notamment pour la réalisation d’une stadification chirurgicale ganglionnaire pelvienne et lombo-aortique. L’utilisation de nouvelles techniques de stadification permettrait de mieux sélectionner les indications de curages ganglionnaires.

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Stratégies ganglionnaires dans les cancers de l’endomètre

Cited by 5 publications

References 62 publications

Reconstruction of Immune Microenvironment and Signaling Pathways in Endometrioid Endometrial Adenocarcinoma During Formation of Lymphovascular Space Involvement and Lymph Node Metastasis

Reconstruction of Immune Microenvironment and Signaling Pathways in Endometrioid Endometrial Adenocarcinoma During Formation of Lymphovascular Space Involvement and Lymph Node Metastasis

Evaluation of Inferior Mesenteric Superior Lymph Node Metastasis in Early-Stage Endometrium Cancer and Its Clinical Significance

Évaluation de l’application des recommandations des cancers de l’endomètre de type 2 : étude rétrospective multicentrique

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