Predictive Score of Nodal Involvement in Endometrial Cancer Patients: A Large Multicentre Series
| Autor: | Giovanni Scambia, Roberto Berretta, Francesco Fanfani, Stefano Uccella, Stefano Restaino, Marcello Ceccaroni, Andrea Rosati, Giulia Gambino, Massimo Franchi, Vito Andrea Capozzi, Giulio Sozzi, Vito Chiantera, Alessandra Cianciolo |
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| Přispěvatelé: | Capozzi V.A., Sozzi G., Rosati A., Restaino S., Gambino G., Cianciolo A., Ceccaroni M., Uccella S., Franchi M., Chiantera V., Scambia G., Fanfani F., Berretta R. |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Sentinel lymph node Logistic regression Biopsy Humans Medicine Endometrial Neoplasm Neoplasm Staging medicine.diagnostic_test business.industry Sentinel Lymph Node Biopsy Endometrial cancer Area under the curve Lymph Node Lymphatic Metastasi Odds ratio medicine.disease Confidence interval Endometrial Neoplasms Oncology Lymphatic Metastasis Lymph Node Excision Surgery Lymphadenectomy Female Lymph Nodes Radiology Sentinel Lymph Node business Human |
| Popis: | Background: Sentinel lymph node (SLN) biopsy is considered the standard of care in early-stage endometrial cancer (EC). For SLN failure, a side-specific lymphadenectomy is recommended. Nevertheless, most hemipelvises show no nodal involvement. The authors previously published a predictive score of lymphovascular involvement in EC. In case of a negative score (value 3–4), the risk of nodal metastases was extremely low. This multicenter study aimed to analyze a predictive score of nodal involvement in EC patients. Methods: The study enrolled patients with EC who had received comprehensive surgical staging with nodal assessment. A preoperative predictive score of nodal involvement was calculated for all the patients before surgery. The score included myometrial infiltration, tumor grading (G), tumor diameter, and Ca125 assessment. The STARD (standards for Reporting Diagnostic accuracy studies) guidelines were followed for score accuracy. Results: The study analyzed 1038 patients and detected 155 (14.9%) nodal metastases. The score was negative (3 or 4) for 475 patients and positive (5–7) for 563 of these patients. The score had a sensitivity of 83.2%, a specificity of 50.8%, a negative predictive value of 94.5%, and a diagnostic value of 55.7%. The area under the curve was 0.75. The logistic regression showed a significant correlation between a negative score and absence of nodal metastasis (odds ration [OR], 5.133, 95% confidence interval [CI], 3.30–7.98; p < 0.001). Conclusion: The proposed predictive score is a useful test to identify patients at low risk of nodal involvement. In case of SLN failure, the application of the current score in the SLN algorithm could allow avoidance of unnecessary lymphadenectomies. |
| Databáze: | OpenAIRE |
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