Abstract
Background
Recently, sentinel lymph node mapping was introduced in the surgical staging of endometrial cancer as alternative to systematic lymphadenectomy. However, the survival impact of sentinel node mapping is not well characterized yet.
Methods
We performed retrospective study of 104 patients with endometrial cancer treated with sentinel lymph node alone (n = 52) or with pelvic and para-aortic lymphadenectomy (n = 52). For sentinel node mapping, indocyanine green was used. The outcome measure was disease-free survival.
Results
Median follow-up was 42 months. Fifty-two patients staged by sentinel lymph node mapping were matched in 1:1 ratio with 52 patients staged by lymphadenectomy using patient age, histological type, tumor stage, tumor grade and lymph and vascular space invasion as matching criteria. The median number of removed lymph node was 3 (range 1–6) and 36 (13–63) in the sentinel and lymphadenectomy group, respectively. The rate of lymph node metastases was not significantly higher in the sentinel group (19.2%) in comparison with the lymphadenectomy group (14.3%). The overall detection rate of sentinel lymph nodes was 100% with a bilateral mapping of 98.1%. Most of the 152 lymph nodes identified and removed were localized in upper paracervical pathway (n = 143, 94.1%). During the follow-up period, overall 21 (20.2%) events were observed, 8 (15.4%) in the sentinel group and 13 (25.0%) in the lymphadenectomy group. The estimated disease-free survival was 84.6% and 75.0% for patients in the sentinel and lymphadenectomy groups, respectively. The survival curves demonstrated similar disease-free survival in two groups (p = 0.774).
Conclusion
Sentinel lymph node mapping did not compromise the outcome of patients with endometrial cancer.
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AI: protocol/project development, data collection, data analysis, manuscript writing/editing. TP: data collection, data analysis, manuscript writing/editing. SI: data collection, data analysis, manuscript writing/editing. OO: data analysis, manuscript writing/editing. HE: protocol/project development, data collection, data analysis, manuscript writing/editing. All authors read and approved the final version of the manuscript.
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This article does not contain any studies with animals performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study before treatment. According to the statement of Research and Ethical Committee, Otto-von-Guericke University, Magdeburg, Germany an additional individual consent was not required for this analysis.
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Ignatov, A., Papathemelis, T., Ivros, S. et al. Comparison of survival of patients with endometrial cancer undergoing sentinel node biopsy alone or systematic lymphadenectomy. Arch Gynecol Obstet 302, 995–1000 (2020). https://doi.org/10.1007/s00404-020-05698-w
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DOI: https://doi.org/10.1007/s00404-020-05698-w