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Prevalence and size of pelvic sentinel lymph node metastases in endometrial cancer

Bollino, Michele LU ; Geppert, Barbara LU ; Lönnerfors, Celine LU ; Måsbäck, Anna LU ; Kasselaki, Ioanna LU and Persson, Jan LU (2024) In European Journal of Cancer 209.
Abstract

Aim of the study: To assess the association of prevalence and size of pelvic sentinel node (SLN) metastases with risk factors in endometrial cancer (EC). Patients and Methods: Between June 2014 and January 2024 consecutive women with a uterine confined EC undergoing robotic surgery including detection of pelvic SLNs at a University Hospital were included. An anatomically based algorithm utilizing Indocyanine green (ICG) as tracer was adhered to. Ultrastaging and immunohistochemistry (IHC) was applied on all SLNs. The prevalence and size of SLN metastases was assessed with regards to pre- and postoperative histologic types and myometrial invasion estimates. Results: Of 1101 included women 72.6 % (759/1045) had low-grade, 7.6 % (79/1045)... (More)

Aim of the study: To assess the association of prevalence and size of pelvic sentinel node (SLN) metastases with risk factors in endometrial cancer (EC). Patients and Methods: Between June 2014 and January 2024 consecutive women with a uterine confined EC undergoing robotic surgery including detection of pelvic SLNs at a University Hospital were included. An anatomically based algorithm utilizing Indocyanine green (ICG) as tracer was adhered to. Ultrastaging and immunohistochemistry (IHC) was applied on all SLNs. The prevalence and size of SLN metastases was assessed with regards to pre- and postoperative histologic types and myometrial invasion estimates. Results: Of 1101 included women 72.6 % (759/1045) had low-grade, 7.6 % (79/1045) high-grade endometroid cancer and 19.8 % (207/1045) non-endometroid cancer. SLN-metastases were present in 174/1045 (16.6 %) women; 9.8 % of preoperatively presumed low-grade endometroid uterine stage 1A (6.4 % of low-grade stage 1A at final histology) and in 58.3 % and 47.8 % respectively in women with high-grade endometroid and non-endometroid uterine stage 1B cancer. In low-grade EC 45/95 (47.4 %) had only isolated tumor cells (ITC) in SLNs compared with 15/78 (19.2 %) in high-grade or non-endometroid cancer (p < .0001) Conclusion: This large population-based study, applying a consequent SLN-algorithm over time, provides important detailed information on the risk for, and size of, SLN metastases within risk groups of EC. The 9.8 % risk for metastases in women with presumed low grade uterine stage 1A endometrioid EC motivates detection of SLNs within this subgroup. The proportion of ITCs in SLNs was significantly lower in higher risk histologies.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Endometrial cancer, Metastasis size Risk groups, Sentinel lymph node
in
European Journal of Cancer
volume
209
article number
114265
publisher
Elsevier
external identifiers
  • scopus:85200972527
  • pmid:39142212
ISSN
0959-8049
DOI
10.1016/j.ejca.2024.114265
language
English
LU publication?
yes
id
943d2830-a4b2-4d3b-a9cf-10f81e798be4
date added to LUP
2024-09-03 14:39:38
date last changed
2024-09-17 15:59:20
@article{943d2830-a4b2-4d3b-a9cf-10f81e798be4,
  abstract     = {{<p>Aim of the study: To assess the association of prevalence and size of pelvic sentinel node (SLN) metastases with risk factors in endometrial cancer (EC). Patients and Methods: Between June 2014 and January 2024 consecutive women with a uterine confined EC undergoing robotic surgery including detection of pelvic SLNs at a University Hospital were included. An anatomically based algorithm utilizing Indocyanine green (ICG) as tracer was adhered to. Ultrastaging and immunohistochemistry (IHC) was applied on all SLNs. The prevalence and size of SLN metastases was assessed with regards to pre- and postoperative histologic types and myometrial invasion estimates. Results: Of 1101 included women 72.6 % (759/1045) had low-grade, 7.6 % (79/1045) high-grade endometroid cancer and 19.8 % (207/1045) non-endometroid cancer. SLN-metastases were present in 174/1045 (16.6 %) women; 9.8 % of preoperatively presumed low-grade endometroid uterine stage 1A (6.4 % of low-grade stage 1A at final histology) and in 58.3 % and 47.8 % respectively in women with high-grade endometroid and non-endometroid uterine stage 1B cancer. In low-grade EC 45/95 (47.4 %) had only isolated tumor cells (ITC) in SLNs compared with 15/78 (19.2 %) in high-grade or non-endometroid cancer (p &lt; .0001) Conclusion: This large population-based study, applying a consequent SLN-algorithm over time, provides important detailed information on the risk for, and size of, SLN metastases within risk groups of EC. The 9.8 % risk for metastases in women with presumed low grade uterine stage 1A endometrioid EC motivates detection of SLNs within this subgroup. The proportion of ITCs in SLNs was significantly lower in higher risk histologies.</p>}},
  author       = {{Bollino, Michele and Geppert, Barbara and Lönnerfors, Celine and Måsbäck, Anna and Kasselaki, Ioanna and Persson, Jan}},
  issn         = {{0959-8049}},
  keywords     = {{Endometrial cancer; Metastasis size Risk groups; Sentinel lymph node}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{European Journal of Cancer}},
  title        = {{Prevalence and size of pelvic sentinel lymph node metastases in endometrial cancer}},
  url          = {{http://dx.doi.org/10.1016/j.ejca.2024.114265}},
  doi          = {{10.1016/j.ejca.2024.114265}},
  volume       = {{209}},
  year         = {{2024}},
}