Low-Volume Lymph Node Metastases in Endometrial Carcinoma
| Autor: | Keith Y. Terada, Lani K. Clinton, Pamela Tauchi-Nishi, Michael E. Carney, David Shimizu, Jordan Kondo |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty Sentinel lymph node Hysterectomy 03 medical and health sciences 0302 clinical medicine Robotic Surgical Procedures Biopsy Carcinoma medicine Humans Lymph node Aged Neoplasm Staging Retrospective Studies Aged 80 and over 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Sentinel Lymph Node Biopsy Endometrial cancer Obstetrics and Gynecology Middle Aged medicine.disease Endometrial Neoplasms Isolated Tumor Cells Dissection medicine.anatomical_structure Oncology Neoplasm Micrometastasis 030220 oncology & carcinogenesis Lymphatic Metastasis Female Lymph Radiology Lymph Nodes business |
| Zdroj: | International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 27(6) |
| ISSN: | 1525-1438 |
| Popis: | ObjectiveThe aim of this study was to determine the histopathologic characteristics of patients with endometrial carcinoma with low-volume metastases (micrometastases and isolated tumor cells) compared with macrometastases.MethodsWe performed a retrospective review of patients with endometrial carcinoma.ResultsAmong 350 robotic-assisted hysterectomies for endometrial cancer, 187 (53%) underwent attempted sentinel lymph node (SLN) biopsy. At least 1 SLN was detected in 185, a 99% overall detection rate; 108 (58%) also had non-SLNs removed. Among 91 patients with SLNs and non-SLNs from the ipsilateral hemipelvis, both were negative in 74 (81%) and positive in 7 (8%), and 10 (11%) had a positive SLN with negative non-SLNs. Among 17 patients with SLNs and non-SLNs from the contralateral hemipelvis, both were negative in 12 (71%), both were positive in 3 (18%), and 2 patients (12%) had negative SLNs with contralateral positive non-SLNs. Among 79 patients with only a SLN dissection, 4 (5%) were positive; among 69 patients with only a non-SLN dissection, 14 (20%) had positive lymph nodes. Among 24 patients with metastatic SLNs, 9 (38%) had isolated tumor cells, 3 (13%) had micrometastases, and 12 (50%) had macrometastases. Among the 40 total patients with metastatic lymph nodes, low-volume metastases represented the largest metastatic deposit in one third of patients, all of which had SLN dissection. All 12 with low-volume metastases had endometrioid histology compared with less than half (46%) of those with macrometastases (P < 0.01). Grade 1 carcinoma was present in 7 (58%) of the patients with low-volume metastases compared with 4 (14%) of those with macrometastases (P < 0.01) Furthermore, significantly more patients with low-volume metastases versus macrometastases had less than 50% myometrial invasion (67% vs 4%, P < 0.001).ConclusionsLow-volume disease was present in one third of patients with nodal metastases, the largest metastatic deposit only in patients who had SLN dissection; these patients were significantly more likely to have grade 1 endometrioid carcinoma with less than 50% myometrial invasion, traditional “low-risk” features. |
| Databáze: | OpenAIRE |
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