Systematic pelvic and aortic lymphadenectomy in intermediate and high-risk endometrial cancer: Lymph-node mapping and identification of predictive factors for lymph-node status

Author(s):  
Christina Fotopoulou ◽  
Konstantinos Savvatis ◽  
Robert Kraetschell ◽  
Joerg C. Schefold ◽  
Werner Lichtenegger ◽  
...  
2020 ◽  
Vol 9 (12) ◽  
pp. 4107
Author(s):  
Damaris Freytag ◽  
Julian Pape ◽  
Juhi Dhanawat ◽  
Veronika Günther ◽  
Nicolai Maass ◽  
...  

Lymph node involvement has been shown to be one of the most relevant prognostic factors in a variety of malignancies; this is also true of endometrial cancer. The determination of the lymph node status is crucial in order to establish the tumor stage, and to consider adjuvant treatment. A wide range of surgical staging practices are currently used for the treatment of endometrial cancer. The necessity and extent of lymph node dissection is an ongoing controversial issue in gynecological oncology. Lymph node surgery in endometrial cancer is technically challenging, and can be time consuming because of the topographic complexity of lymphatic drainage as such, and the fact that the lymph nodes are directly adjacent to both blood vessels and nerves. Therefore, profound and exact knowledge of the anatomy is essential. Sentinel lymph node mapping was recently introduced in surgical staging with the aim of reducing morbidity, whilst also obtaining useful prognostic information from a patient’s lymph node status. The present review summarizes the current evidence on the role of lymph node surgery in endometrial cancer, focusing on the embryological, anatomical, and technical aspects.


2021 ◽  
Vol 11 ◽  
Author(s):  
Lirong Zhai ◽  
Xiwen Zhang ◽  
Manhua Cui ◽  
Jianliu Wang

Endometrial cancer (EC) is known as a common gynecological malignancy. The incidence rate is on the increase annually. Lymph node status plays a crucial role in evaluating the prognosis and selecting adjuvant therapy. Currently, the patients with high-risk (not comply with any of the following: (1) well-differentiated or moderately differentiated, pathological grade G1 or G2; (2) myometrial invasion< 1/2; (3) tumor diameter < 2 cm are commonly recommended for a systematic lymphadenectomy (LAD). However, conventional LAD shows high complication incidence and uncertain survival benefits. Sentinel lymph node (SLN) refers to the first lymph node that is passed by the lymphatic metastasis of the primary malignant tumor through the regional lymphatic drainage pathway and can indicate the involvement of lymph nodes across the drainage area. Mounting evidence has demonstrated a high detection rate (DR), sensitivity, and negative predictive value (NPV) in patients with early-stage lower risk EC using sentinel lymph node mapping (SLNM) with pathologic ultra-staging. Meanwhile, SLNM did not compromise the patient’s progression-free survival (PFS) and overall survival (OS) with low operative complications. However, the application of SLNM in early-stage high-risk EC patients remains controversial. As revealed by the recent studies, SLNM may also be feasible, effective, and safe in high-risk patients. This review aims at making a systematic description of the progress made in the application of SLNM in the treatment of EC and the relevant controversies, including the application of SLNM in high-risk patients.


2015 ◽  
Vol 138 ◽  
pp. 3
Author(s):  
P.T. Soliman ◽  
S.N. Westin ◽  
C.C.L. Sun ◽  
S. Dioun ◽  
M. Frumovitz ◽  
...  

2017 ◽  
Vol 146 (2) ◽  
pp. 234-239 ◽  
Author(s):  
Pamela T. Soliman ◽  
Shannon N. Westin ◽  
Shayan Dioun ◽  
Charlotte C. Sun ◽  
Elizabeth Euscher ◽  
...  

2008 ◽  
Vol 8 (1) ◽  
Author(s):  
Tara J Selman ◽  
Christopher H Mann ◽  
Javier Zamora ◽  
Khalid S Khan

2020 ◽  
Vol 10 ◽  
Author(s):  
Xiang Cui ◽  
Hao Zhu ◽  
Jisheng Huang

BackgroundLymph node metastasis of triple-negative breast cancer (TNBC) is essential in treatment strategy formulation. This study aimed to build a nomogram that predicts lymph node metastasis in patients with TNBC.Materials and MethodsA total of 28,966 TNBC patients diagnosed from 2010 to 2017 in the Surveillance, Epidemiology and End Results (SEER) database were enrolled, and randomized 1:1 into the training and validation sets, respectively. Univariate and multivariate logistic regression analysis were applied to identify the predictive factors, which composed the nomogram. The receiver operating characteristic curves showed the efficacy of the nomogram.ResultMultivariate logistic regression analyses revealed that age, race, tumor size, tumor primary site, and pathological grade were independent predictive factors of lymph node status. Integrating these independent predictive factors, a nomogram was successfully developed for predicting lymph node status, and further validated in the validation set. The areas under the receiver operating characteristic curves of the nomogram in the training and validation sets were 0.684 and 0.689 respectively, showing a satisfactory performance.ConclusionWe constructed a nomogram to predict the lymph node status in TNBC patients. After further validation in additional large cohorts, the nomogram developed here would do better in predicting, providing more information for staging and treatment, and enabling tailored treatment in TNBC patients.


2020 ◽  
Vol 26 (11) ◽  
pp. 2177-2182 ◽  
Author(s):  
David Atallah ◽  
Malak Moubarak ◽  
Wissam Arab ◽  
Nadine El Kassis ◽  
Georges Chahine ◽  
...  

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