Accuracy and Survival Outcomes after National Implementation of Sentinel Lymph Node Biopsy in Early Stage Endometrial Cancer

Sentinel lymph node (SLN) biopsy has recently been accepted to evaluate nodal status in endometrial cancer at early stage, which is key to tailoring adjuvant treatments. Our aim was to evaluate the national implementation of SLN biopsy in terms of accuracy to detect nodal disease in a clinical setti...

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Bibliographic Details
Authors: Cabrera, Silvia, Gómez-Hidalgo, Natalia R, García-Pineda, Virginia, Bebia, Vicente, Fernández-González, Sergi, Alonso, Paula, Rodríguez-Gómez, Tomás, Fusté, Pere, Gracia-Segovia, Myriam, Lorenzo, Cristina, Chacon, Enrique, Roldan Rivas, Fernando, Arencibia, Octavio, Martí Edo, Marina, Fidalgo, Soledad, Sanchis, Josep, Padilla-Iserte, Pablo, Pantoja-Garrido, Manuel, Martínez, Sergio, Peiró, Ricard, Escayola, Cecilia, Oliver-Pérez, M Reyes, Aghababyan, Cristina, Tauste, Carmen, Morales, Sara, Torrent-Colomer, Anna, Utrilla-Layna, Jesus, Fargas, Francesc, Calvo, Ana, Aller de Pace, Laura, Gil-Moreno, Antonio
Format: article
Publication Date:2023
Country:España
Institution:Conselleria de Salut i Consum del Govern de les Illes Balears
Repository:Docusalut
Language:English
OAI Identifier:oai:docusalut.com:20.500.13003/20171
Online Access:https://hdl.handle.net/20.500.13003/20171
Access Level:Open access
Keyword:Neoplasm Staging
Neoplasm Micrometastasis
Lymph Nodes
Endometrial Neoplasms
Sentinel Lymph Node
Sentinel Lymph Node Biopsy
Lymph Node Excision
Female
Humans
Retrospective Studies
Biopsia del Ganglio Linfático Centinela
Humanos
Micrometástasis de Neoplasia
Neoplasias Endometriales
Ganglio Linfático Centinela
Femenino
Estudios Retrospectivos
Estadificación de Neoplasias
Escisión del Ganglio Linfático
Ganglios Linfáticos
Description
Summary:Sentinel lymph node (SLN) biopsy has recently been accepted to evaluate nodal status in endometrial cancer at early stage, which is key to tailoring adjuvant treatments. Our aim was to evaluate the national implementation of SLN biopsy in terms of accuracy to detect nodal disease in a clinical setting and oncologic outcomes according to the volume of nodal disease. A total of 29 Spanish centers participated in this retrospective, multicenter registry including patients with endometrial adenocarcinoma at preoperative early stage who had undergone SLN biopsy between 2015 and 2021. Each center collected data regarding demographic, clinical, histologic, therapeutic, and survival characteristics. A total of 892 patients were enrolled. After the surgery, 12.9% were suprastaged to FIGO 2009 stages III-IV and 108 patients (12.1%) had nodal involvement: 54.6% macrometastasis, 22.2% micrometastases, and 23.1% isolated tumor cells (ITC). Sensitivity of SLN biopsy was 93.7% and false negative rate was 6.2%. After a median follow up of 1.81 years, overall surivial and disease-free survival were significantly lower in patients who had macrometastases when compared with patients with negative nodes, micrometastases or ITC. In our nationwide cohort we obtained high sensitivity of SLN biopsy to detect nodal disease. The oncologic outcomes of patients with negative nodes and low-volume disease were similar after tailoring adjuvant treatments. In total, 22% of patients with macrometastasis and 50% of patients with micrometastasis were at low risk of nodal metastasis according to their preoperative risk factors, revealing the importance of SLN biopsy in the surgical management of patients with early stage EC.

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