Nedim TOKGOZOGLU, Orhan SAHIN, Tolga TAŞÇI, Nur DOKUZEYLÜL GÜNGÖR

The role of paraaortic lymphadenectomy along with sentinel mapping in clinically uterine confined intermediate-high risk endometrial cancer

Objective: This study aimed to find out whether sentinel algorithm can be sufficient in clinically uterine confined intermediate-high risk endometrial cancer. Methods: Detailed pathology characteristics and follow-up records of the 70 intermediate-high risk endometrial cancer patients were identified. Outcomes of patients who are performed sentinel algorithm and sentinel mapping followed by systematic pelvic and paraaortic lymph node dissection were compared. All patients who had obvious extrauterine disease in preoperative and intraoperative evaluation were excluded. Sentinel mapping is performed with methilene blue and cervical injection. Results: 66 patients were identified [sentinel algorithm group, 25; Paraaortic lymph node dissection group, 45]. Paraaortic lymph node dissection group had more high grade patients (p=0,02 ). The mean number of lymph nodes harvested was 11,3 and 36,9, respectively, in sentinel algorithm group and paraaortic lymph node dissection group(p

Keywords:

paraaortic lymphadenectomy, endometrial cancer, sentinel mapping,

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1. Todo Y, Kato H, Kaneuchi M, Watari H, Takeda M, Sakuragi N. Survival effect of para-aortic lymphadenectomy in endometrial cancer (SEPAL study): a retrospective cohort analysis. Lancet 2010; 375: 1165–72
2. The writing committee of behalf of the ASTEC study group. Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial): a randomised study. Lancet 2009; 373: 125−36.
3. Koh WJ, Abu-Rustum NR, Bean S, Bradley K, Campos SM, Cho KR, et al. Uterine Neoplasms, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2018;16:170–99.
4. Colombo N, Creutzberg C, Amant F, Bosse T, Martin AG, Ledermann J, et al. ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: diagnosis, treatment and follow-up. Ann Oncol 2015;117:mdv484.
5. Benedetti Panici P, Basile S, Maneschi F, Lissoni AA, Signorelli M, Scambia G, et al. Systematic Pelvic Lymphadenectomy vs No Lymphadenectomy in Early-Stage Endometrial Carcinoma: Randomized Clinical Trial. J Natl Cancer Inst 2008;100:1707–16.
6. Zahl Eriksson AG, Ducie J, Ali N, McGree ME, Weaver AL, Bogani G, et al. Comparisonof a sentinel lymph node and selective lymphadenectomy algorithm in patients with endometrioid endometrial carcinoma and limited myometrial invasion. Gynecol Oncol 2016;140:394–9.
7. Papadia A, Gasparri ML, Siegenthaler F, Imboden S, Mohr S, Mueller MD. FIGO stage IIIC endometrial cancer identification among patients with complex atypical hyperplasia, grade 1 and 2 endometrioid endometrial cancer: laparoscopic indocyanine green sentinel lymph node mapping versus frozen section of the uterus, why get around the problem? J Cancer Res Clin Oncol 2017;143:491–7.
8. Schlappea BA, Weaverb AL, Duciea JA, Eriksson AGZ, Dowdy SC, Cliby WA, et al. a Multicenter study comparing oncologic outcomes between two nodal assessment methods in patients with deeply invasive endometrioid endometrial carcinoma: a sentinel lymph node algorithm versus a comprehensive pelvic and paraaortic lymphadenectomy. Gynecol Oncol 2018 November ; 151(2): 235–242
9. Mariani A, Dowdy SC, Cliby WA, Gostout BS, Jones MB, Wilson TO, et al. Prospective assessment of lymphatic dissemination in endometrial cancer: a paradigm shift in surgical staging. Gynecol Oncol 109 (2008) 11–18.
10. Karalok A, Turan T, Basaran D, Turkmen O, Kimyon GC, Tulunay G, et al. Lymph Node Metastasis in Patients With Endometrioid Endometrial Cancer Overtreatment Is the Main Issue. Int J Gynecol Cancer 2017;00: 00Y00
11. Mariani A, Webb MJ, Galli L, Podratz GC. Potential Therapeutic Role of Para-aortic Lymphadenectomy in Node-Positive Endometrial Cancer. Gynecol Oncol 2000;76:348–56.
12. Kumar S, Podratz KC, Bakkum-Gamez JN, Dowdy SC, Weaver AL, McGree ME, et al. Prospective assessment of the prevalence of pelvic, paraaortic and high paraaortic lymph node metastasis in endometrialcancer. Gynecol Oncol 2014;132:38–43.
13. Nasioudis D, Holcomb K, Incidence of isolated para-aortic lymph node metastasis in early stage endometrial cancer. Eur J Obstet Gynecol Reprod Biol. 2019 Nov;242:43-46
14. Ruiz R, Gorostidi M, Jaunarena I, Goiri C, Aguerre J, Lekuona A. Sentinel Node Biopsy in Endometrial Cancer With Dual Cervical and Fundal Indocyanine Green Injection. Int J Gynecol Cancer 2018 Jan;28(1):139-144
15. Fotopoulou C, El-Balat A, du Bois A, Sehouli J, Harter P, Muallem MZ, et al. Systematic pelvic and paraaortic lymphadenectomy in early high-risk or advanced endometrial cancer Arch Gynecol Obstet. doi:10.1007/s00404-015-3746-6

Journal of Experimental and Clinical Medicine-Cover

Yayın Aralığı: Yılda 4 Sayı
Başlangıç: 1980
Yayıncı: Ondokuz mayıs Üniversitesi Tıp Fakültesi

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