Real-World Data Assessing the Impact of Lymphovascular Space Invasion on the Diagnostic Performance of Sentinel Lymph Node Mapping in Endometrial Cancer.

Autor: Buechi CA; Department of Obstetrics and Gynecology, Bern University Hospital and University of Bern, 3010 Bern, Switzerland., Siegenthaler F; Department of Obstetrics and Gynecology, Bern University Hospital and University of Bern, 3010 Bern, Switzerland., Sahli L; Department of Obstetrics and Gynecology, Bern University Hospital and University of Bern, 3010 Bern, Switzerland., Papadia A; Department of Gynecology and Obstetrics, Ente Ospedaliero Cantonale of Lugano, 6900 Lugano, Switzerland.; Facoltà di Scienze Biomediche, Università della Svizzera Italiana, 6900 Lugano, Switzerland., Saner FAM; Department of Obstetrics and Gynecology, Bern University Hospital and University of Bern, 3010 Bern, Switzerland., Mohr S; Department of Gynecology and Obstetrics, Bürgerspital Solothurn, 4500 Solothurn, Switzerland., Rau TT; Institute of Pathology, Universitätsklinikum Düsseldorf, 40225 Düsseldorf, Germany., Solass W; Institute of Tissue Medicine and Pathology, University of Bern, 3008 Bern, Switzerland., Imboden S; Department of Obstetrics and Gynecology, Bern University Hospital and University of Bern, 3010 Bern, Switzerland., Mueller MD; Department of Obstetrics and Gynecology, Bern University Hospital and University of Bern, 3010 Bern, Switzerland.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2023 Dec 22; Vol. 16 (1). Date of Electronic Publication: 2023 Dec 22.
DOI: 10.3390/cancers16010067
Abstrakt: Background: SLN mapping has emerged as a standard of care in endometrial cancer due to its high sensitivity and significant reduction in morbidity. Although lymphovascular space invasion (LVSI) is a known risk factor for lymph node metastasis and recurrence, evidence on the reliability of SLN mapping in LVSI-positive patients is scarce. The aim of this study was to determine the impact of LVSI on the diagnostic performance of SLN mapping.
Methods: This retrospective cohort study included patients with endometrial cancer who underwent primary surgical treatment at the Bern University Hospital, Switzerland, between 2012 and 2022.
Results: LVSI was present in 22% of patients and was significantly associated with lymph node metastasis ( p < 0.001) and recurrence ( p < 0.001). In node-negative patients with only SLN mapping performed, LVSI was an independent predictor of recurrence during multivariable Cox regression analysis ( p = 0.036). The negative predictive value of SLN mapping was 91.5% and was significantly lower in tumors with LVSI (75.0%) compared to LVSI-negative tumors (95.6%, p = 0.004).
Conclusion: The presence of LVSI was significantly associated with worse oncological outcomes. LVSI was an independent predictor of recurrence in node-negative patients with only SLN mapping performed. Furthermore, the negative predictive value of SLN mapping was significantly lower in LVSI-positive tumors.
Databáze: MEDLINE
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