| Autor: |
Anna Myriam Perrone, V. Di Donato, Marialuisa Gasparri, Mario Malzoni, Michael D. Mueller, G Bogani, P. Benedetti Panici, Andrea Papadia, A Buda, Francesco Plotti, Jvan Casarin, Roberto Angioli, Ludovico Muzii, Fabio Landoni, Simone Ferrero, Fabio Ghezzi, F. Raspagliesi, P. De Iaco |
| Rok vydání: |
2021 |
| Předmět: |
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| Zdroj: |
Journal of Minimally Invasive Gynecology. 28:S4-S5 |
| ISSN: |
1553-4650 |
| DOI: |
10.1016/j.jmig.2021.09.013 |
| Popis: |
Study Objective Sentinel node mapping (SNM) has replaced lymphadenectomy for staging surgery in apparent early-stage endometrial cancer (EC). Here, we evaluate the long-term survival of three different approaches of nodal assessment. Design A retrospective study evaluating long-term outcomes (at least 3 years of follow-up). Setting Multi-institutional study. Patients or Participants EC patients having nodal assessment between 2006 and 2016. In order to reduce possible confounding factors, we applied a propensity-matched algorithm. Interventions Laparoscopic hysterectomy plus sentinel node mapping and/or lymphadenectomy Measurements and Main Results Charts of 940 patients were evaluated: 174 (18.5%), 187 (19.9%), and 579 (61.6%) having SNM, SNM followed by backup lymphadenectomy and lymphadenectomy, respectively. Applying a propensity score matching algorithm (1:1:2) we selected 500 patients: 125 SNM vs. 125 SNM plus backup lymphadenectomy vs. 250 lymphadenectomy. Baseline characteristics of the study population were similar between groups. The prevalence of nodal disease was 14%, 16%, and 12% in patients having SNM, SNM followed by backup lymphadenectomy and lymphadenectomy, respectively. Overall, 19 (7.6%) patients were diagnosed with low volume nodal disease (7 and 12 patients with micrometastasis and isolated tumor cells). The mean (SD) follow-up time was 62 (±11) months. The survival analysis comparing the three techniques did not show statistical differences in terms of disease-free (p=0.750) and overall survival (p=0.899). Similarly, the type of nodal assessment did not impact survival outcomes after stratification on the basis of uterine risk factors. Conclusion Our study highlighted that SNM provides similar long-term oncologic outcomes than lymphadenectomy. Further evidence is warranted to assess the prognostic value of low-volume disease detected by ultrastaging and the role of molecular/genomic profiling. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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