The impact on survival of two different staging strategies in apparent early stage endometrial cancer comparing sentinel lymph nodes mapping algorithm and selective lymphadenectomy: An Italian retrospective analysis of two reference centers

Giovanni Scambia, Francesco Fanfani, Giorgia Monterossi, Alfredo Ercoli, Alessandro Buda, Giampaolo Di Martino, Stefano Restaino, Elena De Ponti, Daniela Giuliani, Federica Dell'Orto, Tommaso Grassi

Risultato della ricerca: Contributo in rivistaArticolo in rivista

32 Citazioni (Scopus)

Abstract

Objective The role of lymphadenectomy in endometrial cancer is still uncertain. We aimed to evaluate the survival outcomes of two different strategies in apparent uterine confined disease by comparing sentinel lymph node (SLN) mapping and selective lymphadenectomy (LD). Methods We retrospectively reviewed women with preoperative stage I endometrial cancer underwent surgical staging with either SLN mapping, or LD in two Italian centers. Results Eight hundred and two women underwent surgical staging for preoperative stage I endometrial cancer were revised (145 Monza; 657 Rome). All patients underwent peritoneal washing, simple hysterectomy with bilateral salpingo-oophorectomy and nodal staging including SLN mapping, or LD. Overall 8229 lymph nodes were removed (1595 in Monza, 6634 in Rome). Pelvic lymphadenectomy was performed in 33.1% and 52.4% in Monza and Rome, respectively (p < 0.001). Patients with positive pelvic LN were 16.7% and 7.3%, in SLN and LD groups, respectively (p = 0.002). Disease-free survival (DFS) curves did not showed a statistically significant difference between centers and strategies adopted (SLN mapping, LD, SLN + LD) with a HR of 0.87 (95% CI 0.63–2.16; p = 0.475). Conclusions Survival outcomes were similar for both strategies. The SLN strategy allowed to identify a higher rate of stage IIIC1 disease even with a lower median number of lymph node removed in SLN group. Applying a SLN algorithm does not impair the prognosis of endometrial cancer patients. The clinical impact and management of low volume metastasis in high-risk patients should be further clarify.
Lingua originaleEnglish
pagine (da-a)528-534
Numero di pagine7
RivistaGynecologic Oncology
Volume147
DOI
Stato di pubblicazionePubblicato - 2017

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Endometrial Neoplasms
  • Endometrial cancer
  • Female
  • Humans
  • Italy
  • Lymph Node Excision
  • Lymph Nodes
  • Lymphadenectomy
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Staging
  • Obstetrics and Gynecology
  • Oncology
  • Retrospective Studies
  • Sentinel Lymph Node Biopsy
  • Sentinel node mapping
  • Surgical staging

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