To what Extent is Risk Grouping Method Successful in Deciding Surgical Staging in Endometrial Cancer?

Çetinkaya, Kadir; Atalay, Funda; Bacinoglu, Ahmet; Dervişoğlu, Haluk

doi:10.5301/tj.5000497

Cited by 5 publications

(8 citation statements)

References 23 publications

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“…The potential diagnostic value of the SLNM in high-risk patients has been proven in recent years. The DR ranges from 73% to 100%, the BDR varies from 56% to 95%, and NPV ranges from 93% to 100% (5,42,53,72,92,(99)(100)(101)(102)(103)(104)(105)(106)(107). Both SENTI-ENDO study and FIRES studies include low-risk and high-risk EC and present high DR and NPV (64,83).…”

Section: The Application Of Slnm In Early-stage High-risk Ecmentioning

confidence: 99%

“…That is to say, LAD could be omitted in low-risk group (meet all of the following conditions: (1) endometroid type, grade G1 or G2; (2) myometrial invasion< 1/2; and (3) tumor diameter < 2 cm), while LAD should be applied in high-risk group (not in accordance with any of the above). However, evidence has confirmed the ability of the method to identify patients with low risk (1%–2.4%) or high risk [11.4%–19% ( 5 , 20 , 21 )] with a high sensitivity of 90%, which remains the most sensitive method in determining which patients can be omitted from LAD ( 22 ), while the specificity is only 36% ( 4 ). Nearly 80% of the high-risk group without metastases undergo LAD.…”

Section: Disputes About Lad For Ecmentioning

confidence: 99%

“…Recent surveys from ESGO and SGO confirmed that 50.2% ( 128 ) of European gynecological oncologists and 82.7% ( 129 ) of USA gynecologic oncologists adopted SLN in EC. In low-risk patients, who usually do not have to perform LAD, there are 2.4% lymph node metastatic potential ( 5 ), especially in LVSI positive patients ( 7 ). Additionally, LVMD is more likely to occur in low-risk patients ( 130 ).…”

Section: Current Application Of Slnmmentioning

confidence: 99%

“…SLNM can remove fewer lymph nodes with sufficient staging information supporting adjuvant therapy, and will not cause the possibility of post-operative complications to increase compared with hysterectomy alone ( 7 ). In high-risk patients who should undergo LAD, approximately 80% ( 5 , 107 ) of them do not have lymph node metastasis. Moreover, it is difficult for obese patients and patients with severe internal complications to tolerate LAD.…”

Section: Current Application Of Slnmmentioning

confidence: 99%

“…However, studies have revealed that LAD may not be conducive to the prognosis of EC patients ( 2 , 3 ). Besides, the selective lymphadenectomy (SLAD) based on “Mayo criteria” shows a high sensitivity with a low specificity ( 4 ), and 80% of the high-risk patients undergo excessive lymph node dissection ( 5 ). Additionally, lymph node resection brings a series of complications like vascular nerve injury, lymphedema, lymphatic cysts, and so on ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

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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: The Application Of Slnm In Early-stage High-risk Ecmentioning

confidence: 99%

Section: Disputes About Lad For Ecmentioning

confidence: 99%

Section: Current Application Of Slnmmentioning

confidence: 99%

Section: Current Application Of Slnmmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sentinel Lymph Node Mapping in Endometrial Cancer: A Comprehensive Review

et al. 2021

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Sentinel Lymph Node Biopsy in Endometrial Cancer: a New Standard of Care?

Sullivan

Rossi

2017

Curr. Treat. Options in Oncol.

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Lymph node status is one of the most important factors in determining prognosis and the need for adjuvant treatment in endometrial cancer (EMCA). Unfortunately, full lymphadenectomy bears significant surgical and postoperative risks. The majority of patients with clinical stage I disease will not have metastatic disease; thus, a full lymphadenectomy only increases morbidity in this population of patients. The use of the sentinel lymph node (SLN) biopsy has emerged as an alternative to complete lymphadenectomy in EMCA. By removing the highest yield lymph nodes, the SLN biopsy has the same diagnostic ability as lymphadenectomy while minimizing morbidity. The sensitivity of sentinel lymph node identification with robotic fluorescence imaging for detecting metastatic endometrial and cervical cancer (FIRES) trial published this year is the largest prospective, multi-institution trial investigating the accuracy of the SLN biopsy for endometrial and cervical cancer. Results of this trial found an excellent sensitivity (97.2%) and false negative rate (3%) with the technique. The conclusions from the FIRES trial and those of a recent meta-analysis are that SLN biopsy has an acceptable diagnostic accuracy in detecting lymphatic metastases, and can replace lymphadenectomy for this diagnostic purpose. There remains controversy surrounding the SLN biopsy in high-risk disease and the use of adjuvant therapy in the setting of low volume disease detected with ultrastaging. Current data suggests that the technique is accurate in high-risk disease and that the increased detection of metastasis helps guide adjuvant therapy such that oncologic outcomes are likely not affected by forgoing a full lymphadenectomy. Further prospective study is needed to investigate the impact of low volume metastatic disease on oncologic outcomes and the need for adjuvant therapy in these patients.

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Update on Sentinel Lymph Node Mapping in Endometrial Cancer Patients with a High Risk for Nodal Metastasis

Başaran

Leitao

2020

Indian J Gynecol Oncolog

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To what Extent is Risk Grouping Method Successful in Deciding Surgical Staging in Endometrial Cancer?

Cited by 5 publications

References 23 publications

Sentinel Lymph Node Mapping in Endometrial Cancer: A Comprehensive Review

Sentinel Lymph Node Mapping in Endometrial Cancer: A Comprehensive Review

Sentinel Lymph Node Biopsy in Endometrial Cancer: a New Standard of Care?

Update on Sentinel Lymph Node Mapping in Endometrial Cancer Patients with a High Risk for Nodal Metastasis

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