DNA ploidy in curettage specimens identifies high-risk patients and lymph node metastasis in endometrial cancer

Objective To establish a dynamic nomogram based on preoperative clinical data for prediction of lateral lymph node metastasis (LLNM) of papillary thyroid carcinoma. Study Design Retrospective study. Setting The Sixth Affiliated Hospital of Sun Yat-Sen University. Methods The data of 477 patients from 2 centers formed the training group and validation group and were retrospectively reviewed. Preoperative clinical factors influencing LLNM were identified by univariable and multivariable analysis and were to construct a predictive dynamic nomogram for LLNM. Receiver operating characteristic analysis and calibration curves were used to evaluate the predictive power of the nomogram. Results The following were identified as independent risk factors for LLNM: male sex (odds ratio [OR] = 4.6, P = .04), tumor size ≥10.5 mm (OR = 7.9, P = .008), thyroid nodules (OR = 6.1, P = .013), irregular tumor shape (OR = 24.6, P = .001), rich lymph node vascularity (OR = 9.7, P = .004), and lymph node location. The dynamic nomogram constructed with these factors is available at https://zxh1119.shinyapps.io/DynNomapp/ . The nomogram showed good performance, with an area under the curve of 0.956 (95% CI, 0.925-0.986), a sensitivity of 0.87, and a specificity of 0.91, if high-risk patients were defined as those with a predicted probability ≥0.3 or total score ≥200. The nomogram performed well in the external validation cohort (area under the curve, 0.915; 95% CI, 0.862-0.967). Conclusions The dynamic nomogram for preoperative prediction of LLNM in papillary thyroid carcinoma can help surgeons identify high-risk patients and develop individualized treatment plans.

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Predictors of Survival in Women with High-Risk Endometrial Cancer and Comparisons of Sandwich versus Concurrent Adjuvant Chemotherapy and Radiotherapy

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17165941 ◽

2020 ◽

Vol 17 (16) ◽

pp. 5941

Author(s):

Hui-Hua Chen ◽

Wan-Hua Ting ◽

Hsu-Dong Sun ◽

Ming-Chow Wei ◽

Ho-Hsiung Lin ◽

...

Keyword(s):

Body Mass Index ◽

Endometrial Cancer ◽

Lymph Node ◽

High Risk ◽

Lymph Node Metastasis ◽

Cancer Patients ◽

Body Mass ◽

Paraaortic Lymph Node ◽

Node Metastasis ◽

Paraaortic Lymph Node Metastasis

Background: to elucidate the predictors of progression-free survival (PFS) and overall survival (OS) in high-risk endometrial cancer patients. Methods: the medical records of all consecutivewomen with high-risk endometrial cancer were reviewed. Results: among 92 high-risk endometrial cancer patients, 30 women experienced recurrence, and 21 women died. The 5-year PFS and OS probabilities were 65.3% and 75.9%, respectively. Multivariable Cox regression revealed that body mass index (hazard ratio (HR) = 1.11), paraaortic lymph node metastasis (HR = 11.11), lymphovascular space invasion (HR = 5.61), and sandwich chemoradiotherapy (HR = 0.15) were independently predictors of PFS. Body mass index (HR = 1.31), paraaortic lymph node metastasis (HR = 32.74), non-endometrioid cell type (HR = 11.31), and sandwich chemoradiotherapy (HR = 0.07) were independently predictors of OS. Among 51 women who underwent sandwich (n = 35) or concurrent (n = 16) chemoradiotherapy, the use of sandwich chemoradiotherapy were associated with better PFS (adjusted HR = 0.26, 95% CI = 0.08–0.87, p = 0.03) and OS (adjusted HR = 0.11, 95% CI = 0.02–0.71, p = 0.02) compared with concurrent chemoradiotherapy. Conclusion: compared with concurrent chemoradiotherapy, sandwich chemoradiotherapy was associated with better PFS and OS in high-risk endometrial cancer patients. In addition, high body mass index, paraaortic lymph node metastasis, and non-endometrioid cell type were also predictors of poor OS in high-risk endometrial cancer patients.

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Sentinel lymph node sampling is associated with better survival outcome in intermediate-high risk patients with endometrial cancer

Gynecologic Oncology ◽

10.1016/j.ygyno.2020.05.352 ◽

2020 ◽

Vol 159 ◽

pp. 215-216

Author(s):

E. Matanes ◽

C. Mitric ◽

Z. Amajoud ◽

J. Abitbol ◽

N. Eisenberg ◽

...

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

High Risk ◽

Sentinel Lymph Node ◽

Survival Outcome ◽

High Risk Patients ◽

Lymph Node Sampling ◽

Risk Patients

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Implications of Isolated Para-Aortic Lymph Node Metastasis in Endometrial Cancer: A Large-Scale, Multicenter, and Retrospective Study

Frontiers in Medicine ◽

10.3389/fmed.2021.754890 ◽

2021 ◽

Vol 8 ◽

Author(s):

Wenting Li ◽

Jie Jiang ◽

Yu Fu ◽

Yuanming Shen ◽

Chuyao Zhang ◽

...

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Large Scale ◽

Low Risk ◽

Surgical Staging ◽

Node Metastasis ◽

Aortic Lymph Node ◽

Risk Patients ◽

Metastatic Sites

Objective: To systematically evaluate lymph node metastasis (LNM) patterns in patients with endometrial cancer (EC) who underwent complete surgical staging, which included systematic pelvic and para-aortic lymphadenectomy.Methods: Four thousand and one patients who underwent complete surgical staging including systematic pelvic and para-aortic lymphadenectomy for EC were enrolled from 30 centers in China from 2001 to 2019. We systematically displayed the clinical and prognostic characteristics of patients with various LNM patterns, especially the PLN-PAN+ [para-aortic lymph node (PAN) metastasis without pelvic lymph node (PLN) metastasis]. The efficacy of PAN+ (para-aortic lymph node metastasis) prediction with clinical and pathological features was evaluated.Results: Overall, 431 of the 4,001 patients (10.8%) showed definite LNM according to pathological diagnosis. The PAN+ showed the highest frequency (6.6%) among all metastatic sites. One hundred fourteen cases (26.5%) were PLN-PAN+ (PAN metastasis without PLN metastasis), 167 cases (38.7%) showed PLN+PAN-(PLN metastasis without PAN metastasis), and 150 cases (34.8%) showed metastasis to both regions (PLN+PAN+). There was also 1.9% (51/2,660) of low-risk patients who had PLN-PAN+. There are no statistical differences in relapse-free survival (RFS) and disease-specific survival (DSS) among PLN+PAN-, PLN-PAN+, and PLN+PAN+. The sensitivity of gross PLNs, gross PANs, and lymphovascular space involvement (LVSI) to predict PAN+ was 53.8 [95% confidence interval (CI): 47.6–59.9], 74.2 95% CI: 65.6–81.4), and 45.8% (95% CI: 38.7–53.2), respectively.Conclusion: Over one-fourth of EC patients with LMN metastases were PLN-PAN+. PLN-PAN+ shares approximate survival outcomes (RFS and DSS) with other LNM patterns. No effective clinical methods were achieved for predicting PAN+. Thus, PLN-PAN+ is a non-negligible LNM pattern that cannot be underestimated in EC, even in low-risk patients.

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A Predictive Model Using Histopathologic Characteristics of Early-Stage Type 1 Endometrial Cancer to Identify Patients at High Risk for Lymph Node Metastasis

Annals of Surgical Oncology ◽

10.1245/s10434-015-4548-6 ◽

2015 ◽

Vol 22 (13) ◽

pp. 4224-4232 ◽

Cited By ~ 14

Author(s):

Sofiane Bendifallah ◽

Geoffroy Canlorbe ◽

Enora Laas ◽

Florence Huguet ◽

Charles Coutant ◽

...

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

High Risk ◽

Lymph Node Metastasis ◽

Predictive Model ◽

Early Stage ◽

Node Metastasis

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Utility of PET/CT to Evaluate Retroperitoneal Lymph Node Metastasis in High-Risk Endometrial Cancer: Results of ACRIN 6671/GOG 0233 Trial

Radiology ◽

10.1148/radiol.2016160200 ◽

2017 ◽

Vol 283 (2) ◽

pp. 450-459 ◽

Cited By ~ 22

Author(s):

Mostafa Atri ◽

Zheng Zhang ◽

Farrokh Dehdashti ◽

Susanna I. Lee ◽

Helga Marques ◽

...

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

High Risk ◽

Lymph Node Metastasis ◽

Retroperitoneal Lymph Node ◽

Node Metastasis ◽

Pet Ct

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Sentinel Lymph Node Mapping in Endometrial Cancer: A Comprehensive Review

Frontiers in Oncology ◽

10.3389/fonc.2021.701758 ◽

2021 ◽

Vol 11 ◽

Author(s):

Lirong Zhai ◽

Xiwen Zhang ◽

Manhua Cui ◽

Jianliu Wang

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

High Risk ◽

Sentinel Lymph Node ◽

Early Stage ◽

Sentinel Lymph Node Mapping ◽

Lymph Node Status ◽

Lymph Node Mapping ◽

High Risk Patients ◽

Risk Patients

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.

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Utility of PET-CT to evaluate retroperitoneal lymph node metastasis in high risk endometrial cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.15_suppl.5524 ◽

2015 ◽

Vol 33 (15_suppl) ◽

pp. 5524-5524 ◽

Cited By ~ 1

Author(s):

Mostafa Atri ◽

Zheng Zhang ◽

Farrokh Dehdashti ◽

Wui-Jin Koh ◽

Shamshad Ali ◽

...

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

High Risk ◽

Lymph Node Metastasis ◽

Retroperitoneal Lymph Node ◽

Node Metastasis ◽

Pet Ct

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Is there a correlation between Gleason score and maximum standardized uptake value in locally advanced prostate cancer patients?

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.7_suppl.68 ◽

2019 ◽

Vol 37 (7_suppl) ◽

pp. 68-68

Author(s):

Onal Cem ◽

Nese Torun ◽

Ozan Cem Guler ◽

Mehmet Reyhan ◽

Berna Akkus Yildrim ◽

...

Keyword(s):

Prostate Cancer ◽

Lymph Node ◽

High Risk ◽

Lymph Node Metastasis ◽

Regional Lymph Node ◽

Primary Tumour ◽

Regional Lymph Node Metastasis ◽

Intermediate Risk ◽

Node Metastasis ◽

Risk Patients

68 Background: The aim was to assess the intensity of 68Ga-PSMA uptake in the primary tumour in patients locally advanced prostate cancer treated with definitive radiotherapy. Also correlation between the maximum standardized uptake value (SUVmax) of primary tumour and the Gleason score (GS) or prostate-specific antigen (PSA) level was assessed. Methods: The data of 201 biopsy-proven prostated cancer patients were retrospectively analysed. Median age of entire cohort was 68 years (range; 45 – 85 years). PET/CT images were analysed visually and semiquantitatively by measuring the SUVmax. The SUVmax of the primary tumour was assessed in relation to both PSA level and GS. Results: Median age of entire cohort was 68 years (ranged 45 – 85 years). Median PSA value at diagnosis was 20.3 ng/mL (ranged 2.1 – 301.0 ng/mL). Forty-two patients (23.9%) was in intermediate risk group, and 159 patients (79.1%) had high risk disease. Seventy two patients (36.8%) had regional lymph node metastasis. Median SUVmax of primary tumor and metastatic lymph nodes were 13.0 (ranged 1.3 - 84.3) and 12.6 (ranged 3.6 – 64.5), respectively. Patients with GS 7 or lower had significantly lower SUVmax compared to patients with GS > 7 (12.1±8.4 vs. 20.9±16.4; p < 0.001). However, there was no significant difference in SUVmax of tumors with GS of 3+4 and 4+3 (14.8±8.6 vs. 16.3±12.7; p = 0.6). Patients with PSA ≥10.0 ng/mL exhibited significantly higher uptake than those with PSA levels < 10.0 ng/mL (12.1±8.4 vs. 20.9±16.4; p < 0.001). SUVmax of intermediate risk patients was significantly lower than that of high risk patients (12.7±11.1 vs. 19.8±16.8; p = 0.01). In 72 patients with lymph node metastasis SUVmax was significantly higher compared to 129 patients without lymph node metastasis (24.9±21.3 vs. 14.7±10.6; p < 0.001). Conclusions: Tumours with GS 7 or lower, patients with PSAvalues ≤10 ng/mL, intermediate risk patients and patients without regional lymph node metastasis showed significantly lower 68Ga-PSMA uptake. 68Ga-PSMA-PET/CT should be preferentially applied for primary staging of prostate cancer in patients with GS > 7, PSA levels ≥10 ng/ml, high risk patients and patients with regional lymph node metastasis.

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