Precaval positive sentinel lymph node with bilateral negative pelvic sentinel lymph node in low-risk endometrial cancer patient

2019 ◽  
Vol 48 (10) ◽  
pp. 887-889 ◽  
Author(s):  
R. Montero Macias ◽  
V. Balaya ◽  
H. Bonsang-Kitzis ◽  
M. Deloménie ◽  
M. Gosset ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Cancer Patient ◽  
Positive Sentinel Lymph Node ◽  
Low Risk ◽  
Endometrial Cancer Patient

scholarly journals Minimally Invasive Surgery and Sentinel Lymph Node Biopsy – a Modern Standart of Uterine Confined Endometrial Cancer Treatment: Reviewing Literature and Presenting the National Cancer Institute Experience

2020 ◽  
Vol 19 (3-4) ◽  
pp. 120-127
Author(s):  
Rūta Čiurlienė ◽  
Diana Žilovič ◽  
Karolina Eva Romeikienė ◽  
Evelina Šidlovska
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Postoperative Complications ◽  
National Cancer Institute ◽  
Lymph Node Biopsy ◽  
Low Risk ◽  
Node Biopsy ◽  
Group I

Objectives. To find out sentinel lymph node detection rate of low-risk endometrial cancer patients. To compare postoperative complications rate, lenght of a surgery, lenght of hospital stay and sensitivity of detecting lymph node metastasis between minimally invasive surgery with sentinel lymph node biopsy and abdominal surgery with systemic pelvic lymphadenectomy. Methods. Retrospective analysis of low-risk endometrial cancer patients, treated in National Cancer Institute (n = 103) history cases from 2018 10 untill 2019 12. I group – laparoscopic hysterectomy with sentinel lymph node biopsy (n = 35); II group – abdominal hysterectomy with systemic pelvic lymphadenectomy (n = 68). Both groups were homogeneous according to clinicopathological features. Results. Sentinel lymph node were detected in 97.1% cases. Sentinel lymph nodes in both sides were detected in 85.7% cases. Metastasis in regional lymph nodes were detected in 2 cases (5.7%) in group I and none group II. Postoperative complications rate in group I were 3.8% and 13% in group II. Conclusions. There are significantly less postoperative complications in endoscopic surgery with sentinel node biopsy for low-risk endometrial cancer treatment, also this method is more accurate in surgical staging in National Cancer Institute.

Oncological safety and perioperative morbidity in low-risk endometrial cancer with sentinel lymph-node dissection

2019 ◽  
Vol 45 (9) ◽  
pp. 1638-1643 ◽  
Author(s):  
Sara Imboden ◽  
Liliana Mereu ◽  
Franziska Siegenthaler ◽  
Alice Pellegrini ◽  
Andrea Papadia ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Node Dissection ◽  
Low Risk ◽  
Sentinel Lymph Node Dissection ◽  
Node Dissection ◽  
Perioperative Morbidity ◽  
Oncological Safety

scholarly journals The Advantage of Pinpoint Camera System With Indocyanine Green for Sentinel Lymph Node Micrometastasis Detection in Low Risk Endometrial Cancer

In Vivo ◽  
2021 ◽  
Vol 35 (2) ◽  
pp. 1033-1039
Author(s):  
ALEXANDROS LAZARIDIS ◽  
STYLIANOS KOGEORGOS ◽  
PANAGIOTIS BALINAKOS ◽  
KITTY PAVLAKIS ◽  
THEOFANI GAVRESEA ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Indocyanine Green ◽  
Low Risk ◽  
Camera System ◽  
Lymph Node Micrometastasis

A cost-utility analysis of sentinel lymph node mapping, selective lymphadenectomy, and routing lymphadenectomy in the management of low-risk endometrial cancer.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 10-10 ◽  
Author(s):  
Rudy Sam Suidan ◽  
Charlotte C. Sun ◽  
Scott B. Cantor ◽  
Andrea Mariani ◽  
Pamela T. Soliman ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Mapping ◽  
Cost Effective ◽  
Cost Utility ◽  
Low Risk ◽  
Effective Strategy ◽  
Lymph Node Mapping ◽  
Cost Effective Strategy

10 Background: Our objective was to evaluate the cost-utility of 3 lymphadenectomy (LND) strategies in the treatment of low-risk endometrial cancer (EC). Methods: A decision analysis model compared 3 LND strategies in women undergoing minimally invasive surgery (MIS) for EC: 1) routine LND in all pts; 2) selective LND based on intraoperative frozen section, in which 60% of pts undergo LND; and 3) sentinel lymph node mapping (SLN) based on a published algorithm, in which 15% of pts map unilaterally (requiring a contralateral LND) and 5% don’t map (requiring bilateral LND). Costs and outcomes were obtained from published literature and Medicare reimbursement rates. Costs categories consisted of hospital, physician, operating room, pathology, and lymphedema treatment. Effectiveness was defined as 3-year disease-specific survival adjusted for the impact of lymphedema (utility = 0.8) on quality of life. Incremental cost-effectiveness ratios (ICERs) per quality-adjusted life years (QALYs) gained were calculated. QALYs and costs were discounted at an annual 3% rate. Results: For the estimated 40,000 women undergoing surgery for low-risk EC each year in the US, the annual cost of routine LND, selective LND, and SLN is $722 million, $681 million, and $656 million respectively. In the base case scenario, routine LND had a cost of $18,041 and an effectiveness of 2.79 QALYs. Selective LND had a cost of $17,036 and an effectiveness of 2.81 QALYs, while SLN had a cost of $16,401 and an effectiveness of 2.87 QALYs. With a difference of $1,005 and 0.02 QALYs, selective LND was both less costly and more effective than routine LND, dominating it. However, with the lowest cost and highest effectiveness, SLN dominated the other modalities and was the most cost-effective strategy. No ICER could be determined. These findings were robust to multiple one- and two-way sensitivity analyses varying the rates of lymphedema and LND, surgical approach (open or MIS), lymphedema utility, and costs. Conclusions: Compared to routine and selective LND, SLN had the lowest cost and highest quality-adjusted survival, making it the most cost-effective strategy in the management of low-risk EC.

Combination of sentinel lymph node mapping and uterine frozen section examination to reduce side-specific lymphadenectomy rate in endometrial cancer: a Turkish Gynecologic Oncology Group study (TRSGO-SLN-002)

2020 ◽  
Vol 30 (7) ◽  
pp. 1005-1011
Author(s):  
Duygu Altin ◽  
Salih Taşkın ◽  
Ilker Kahramanoglu ◽  
Dogan Vatansever ◽  
Nedim Tokgozoglu ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Frozen Section ◽  
Myometrial Invasion ◽  
Pelvic Lymphadenectomy ◽  
Low Risk ◽  
Tumor Diameter ◽  
Diagnostic Efficacy ◽  
Frozen Section Examination

ObjectiveThis study aimed to find out whether side-specific pelvic lymphadenectomy can be omitted without compromising diagnostic efficacy according to “reflex frozen section” analysis of the uterus in case of sentinel lymph node (SLN) mapping failure.MethodsPatients who underwent surgery for endometrial cancer with an SLN algorithm were stratified as low-risk or high-risk according to the uterine features on the final pathology reports. Two models for low-risk patients were defined to omit side-specific pelvic lymphadenectomy: strategy A included patients with endometrioid histology, grade 1–2, and <50% myometrial invasion irrespective of the tumor diameter; strategy B included all factors of strategy A with the addition of tumor diameter ≤2 cm. Theoretical side-specific pelvic lymphadenectomy rates were calculated for the two strategies, assuming side-specific pelvic lymphadenectomy was omitted if low-risk features were present on reflex uterine frozen examination, and compared with the standard National Comprehensive Cancer Network (NCCN) SLN algorithm.Results372 endometrial cancer patients were analyzed. 230 patients (61.8%) had endometrioid grade 1 or 2 tumors with <50% myometrial invasion (strategy A), and in 123 (53.4%) of these patients the tumor diameter was ≤2 cm (strategy B); 8 (3.5%) of the 230 cases had lymphatic metastasis. None of them were detected by side-specific pelvic lymphadenectomy and metastases were limited to SLNs in 7 patients. At least one pelvic side was not mapped in 107 (28.8%) cases in the entire cohort, and all of these cases would require a side-specific pelvic lymphadenectomy based on the NCCN SLN algorithm. This rate could have been significantly decreased to 11.8% and 19.4% by applying reflex frozen section examination of the uterus using strategy A and strategy B, respectively.ConclusionReflex frozen section examination of the uterus can be a feasible option to decide whether side-specific pelvic lymphadenectomy is necessary for all the patients who failed to map with an SLN algorithm. If low-risk factors are found on frozen section examination, side-specific pelvic lymphadenectomy can be omitted without compromising diagnostic efficacy for lymphatic spread.

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