scholarly journals The impact of sentinel lymph node sampling versus traditional lymphadenectomy on the survival of patients with stage IIIC endometrial cancer

2021 ◽  
pp. ijgc-2021-002450
Author(s):  
Dimitrios Nasioudis ◽  
Maureen Byrne ◽  
Emily M Ko ◽  
Robert L Giuntoli II ◽  
Ashley F Haggerty ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lymph Node Biopsy ◽  
Rank Test ◽  
Systematic Lymphadenectomy ◽  
Log Rank Test ◽  
Node Biopsy ◽  
To Receive

ObjectiveTo investigate the survival of patients with lymph node positive endometrial carcinoma by type of surgical lymph node assessment.MethodsPatients diagnosed between January 2012 and December 2015 with endometrial carcinoma and uterine confined disease and nodal metastases on final pathology who underwent minimally invasive hysterectomy were identified in the National Cancer Database. Patients who had sentinel lymph node biopsy alone or underwent systematic lymphadenectomy were selected. Overall survival was evaluated following generation of Kaplan–Meier curves and compared with the log rank test. A Cox model was constructed to evaluate survival after controlling for confounders.ResultsA total of 1432 patients were identified: 1323 (92.4%) and 109 (7.6%) underwent systematic lymphadenectomy and sentinel lymph node biopsy only, respectively. The rate of adjuvant treatment was comparable between patients who had sentinel lymph node biopsy alone and systematic lymphadenectomy (83.5% vs 86.6%, p=0.39). However, patients who had sentinel lymph node biopsy were less likely to receive chemotherapy alone (13.6% vs 36.6%, p<0.001) and more likely to receive radiation therapy alone (19.8% vs 5.4%, p<0.001) compared with patients who had systematic lymphadenectomy. There was no difference in overall survival between patients who had sentinel lymph node biopsy alone and systematic lymphadenectomy (p=0.27 from log rank test), and 3 year overall survival rates were 82.2% and 79.4%, respectively (p>0.05). After controlling for confounders, there was no difference in survival between the systematic lymphadenectomy and sentinel lymph node biopsy alone groups (hazard ratio 0.82, 95% confidence interval 0.46 to 1.45).ConclusionsPerformance of sentinel lymph node biopsy alone was not associated with an adverse impact on survival in patients with lymph node positive endometrial cancer.

SENTINEL LYMPH NODE BIOPSY IN EARLY BREAST CANCER: THE EXPERIENCE OF THE N.N. PETROV RESEARCH INSTITUTE OF ONCOLOGY

2017 ◽  
Vol 63 (2) ◽  
pp. 267-273 ◽  
Author(s):  
Petr Krivorotko ◽  
Konstantin Zernov ◽  
Ruslan Paltuev ◽  
Anna Artemeva ◽  
Yelena Turkevich ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Early Breast Cancer ◽  
Lymph Node Biopsy ◽  
Node Biopsy ◽  
Biologic Subtype ◽  
Research Institute

The aim of the study was to evaluate a 3-year distant treatment outcomes of patients with early breast cancer who had undergone sentinel lymph node biopsy. Methods. A total of 681 patients with early cT1-2N0M0 breast cancer treated in the N.N. Petrov research institute of oncology form 2012 till 2016 were retrospectively enrolled in the study. Radioisotopes were used to identify sentinel nodes. In case a macrometastatic lesion was found (>2mm) ALND was performed. Subsequent adequate systemic treatment and radiotherapy were administered in accordance with the pTNM status, biologic subtype and age. Results. A 3-year overall survival equaled 99.3% (SE 0.4%), recurrence-free survival was 99.2% (SE 0.4%). Survival of patients without nodal involvement reached 100%, whereas for patients with metastatic nodes it was 97.4% (SE 1.8%). The threshold for the number of the affected nodes significantly influencing survival equaled 1 (р=0,0187). Overall survival of patients with 0 to 1 positive lymph nodes was 99.7% (SE 0.3%), with more than 1 node involved - 95.7% (SE 0.3%) (р=0,00444). Conclusion. Overall 3-year survival of patients with early breast cancer approaches 100%. Sentinel lymph node biopsy allows avoiding unnecessary and traumatizing axillary dissection and improves the quality of life.

scholarly journals Status of Sentinel Lymph Node Biopsy in Endometrial Cancer

2021 ◽  
Vol 81 (05) ◽  
pp. 562-573
Author(s):  
Florin Andrei Taran ◽  
Lisa Jung ◽  
Julia Waldschmidt ◽  
Sarah Isabelle Huwer ◽  
Ingolf Juhasz-Böss
Keyword(s):  
Endometrial Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lymph Node Biopsy ◽  
Current Data ◽  
Predictive Values ◽  
Systematic Lymphadenectomy ◽  
European Guidelines ◽  
Node Biopsy

AbstractThe role of lymphadenectomy in surgical staging remains one of the biggest controversies in the management of endometrial cancer. The concept of sentinel lymph node biopsy in endometrial cancer has been evaluated for a number of years, with promising sensitivity rates and negative predictive values. The possibility of adequate staging while avoiding systematic lymphadenectomy leads to a significant reduction in the rate of peri- and postoperative morbidity. Nevertheless, the status of sentinel lymph node biopsy in endometrial cancer has not yet been fully elucidated and is variously assessed internationally. According to current European guidelines and recommendations, sentinel lymph node biopsy in endometrial cancer should be performed only in the context of clinical studies. In this review article, the developments of the past decade are explored concisely. In addition, current data regarding the technical aspects, accuracy and prognostic relevance of sentinel lymph node biopsy are explained and evaluated critically.

Sentinel lymph node evaluation among elderly melanoma patients: Missed opportunities?

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19001-e19001
Author(s):  
Dhruvil R Shah ◽  
Anthony D Yang ◽  
Emanual Maverakis ◽  
Steve R. Martinez
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Elderly Patients ◽  
Sentinel Node ◽  
Sentinel Node Biopsy ◽  
Cutaneous Melanoma ◽  
Lymph Node Biopsy ◽  
Node Biopsy ◽  
To Receive

e19001 Background: Elderly patients may not receive indicated therapies offered to younger patients. We hypothesized that elderly patients with intermediate thickness cutaneous melanoma would be less likely to receive a sentinel lymph node biopsy than their younger counterparts. Methods: The Surveillance, Epidemiology, and End Results database was queried for patients who underwent surgery for intermediate thickness cutaneous melanoma (Breslow thickness 0.75 to 4.00 mm) from 2004 to 2008. We excluded patients with mucosal melanoma, those without a biopsy-proven diagnosis, and those diagnosed at autopsy. Patients were categorized according to age by decade. We used multivariate logistic regression models to predict use of sentinel lymph node biopsy. Additional covariates other than age included sex, race/ethnicity, T stage, tumor histology, tumor location, ulceration, and LDH status. Likelihood of undergoing sentinel lymph node biopsy was reported as odds ratios (OR) with 95% confidence intervals (CI); significance was set at p ≤ 0.05. Results: Among 12,283 patients with intermediate thickness cutaneous melanoma, 12,206 had complete information regarding the use of sentinel lymph node biopsy. Of these, 6,642 (54.4%) underwent sentinel node biopsy. On multivariate analysis, patients in the two oldest age categories were less likely to receive sentinel node biopsies (age 70 to 79 years OR 0.65, CI 0.55-0.76 and age 80 years or more OR 0.29, CI 0.24-0.35). Additional factors associated with a decreased likelihood of receiving a sentinel node biopsy included head and neck primary tumor site (OR 0.57, CI 0.51-0.64), high (OR 0.45, CI 0.31-0.65) or unknown (OR 0.32, CI 0.28-0.36) serum LDH, Asian (OR 0.58, CI 0.36-0.94) or unknown (OR 0.51, CI 0.36-0.72) race, and lentigo histology (OR 0.79, CI 0.66-0.95). Conclusions: Elderly patients with intermediate thickness melanoma are less likely to receive sentinel node biopsy than their younger counterparts. The elderly may benefit from sentinel node biopsy, and efforts should be made to increase performance of this procedure in this population. Further research to assess reasons why the elderly are less likely to receive sentinel node biopsy are needed.

scholarly journals Overall survival after surgical staging by lymph node dissection versus sentinel lymph node biopsy in endometrial cancer: a national cancer database study

2021 ◽  
pp. ijgc-2021-002927
Author(s):  
Simone Garzon ◽  
Andrea Mariani ◽  
Courtney N Day ◽  
Elizabeth B Habermann ◽  
Carrie Langstraat ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Sentinel Node ◽  
Sentinel Node Biopsy ◽  
Lymph Node Biopsy ◽  
Node Biopsy ◽  
Node Status

ObjectiveSubstituting lymphadenectomy with sentinel lymph node biopsy for staging purposes in endometrial cancer has raised concerns about incomplete nodal resection and detrimental oncological outcomes. Therefore, this study aimed to investigate the association between the type of lymph node assessment and overall survival in endometrial cancer accounting for node status and histology.MethodsWomen with stage I–III endometrial cancer who underwent hysterectomy and lymph node assessment from January 2012 to December 2015 were identified in the National Cancer Database. Patients who underwent neoadjuvant therapy, had previous cancer, and whose follow-up was less than 90 days were excluded. Multivariable Cox proportional hazards regression analyses were performed to assess factors associated with overall survival.ResultsOf 68 614 patients, 64 796 (94.4%) underwent lymphadenectomy, 1777 (2.6%) underwent sentinel node biopsy only, and 2041 (3.0%) underwent both procedures. On multivariable analysis, neither sentinel lymph node biopsy alone nor sentinel node biopsy followed by lymphadenectomy was associated with significantly different overall survival compared with lymphadenectomy alone (HR 0.92, 95% CI 0.73 to 1.17, and HR 0.91, 95% CI 0.77 to 1.08, respectively). When stratified by lymph node status, sentinel node biopsy alone or followed by lymphadenectomy was not associated with different overall survival, both in patients with negative (HR 0.95, 95% CI 0.73 to 1.24, and HR 1.04, 95% CI 0.85 to 1.27, respectively) or positive (HR 0.91, 95% CI 0.54 to 1.52, and HR 0.77, 95% CI 0.57 to 1.04, respectively) lymph nodes. These findings held true when sentinel node biopsy alone and sentinel node biopsy plus lymphadenectomy groups were merged, and on stratification by histotype (type one vs type 2) or inclusion of only complete lymphadenectomy (at least 10 pelvic nodes and at least one para-aortic node removed). In all analyses, age, Charlson-Deyo score, black race, AJCC pathological T stage, grade, lymphovascular invasion, brachytherapy, and adjuvant chemotherapy were independently associated with overall survival.DiscussionNo difference in overall survival was found in patients with endometrial cancer who underwent sentinel node biopsy alone, sentinel node biopsy followed by lymphadenectomy, or lymphadenectomy alone. This observation remained regardless of node status, histotype, and lymphadenectomy extent.

Utilization and outcomes of sentinel lymph node biopsy in patients with early stage vulvar cancer

2020 ◽  
Vol 31 (1) ◽  
pp. 40-44
Author(s):  
Catherine E Hermann ◽  
Dimitrios Nasioudis ◽  
Spyridon A Mastroyannis ◽  
Nawar A Latif ◽  
Ashley F Haggerty ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Sentinel Node ◽  
Sentinel Node Biopsy ◽  
Vulvar Cancer ◽  
Lymph Node Biopsy ◽  
Perioperative Outcomes ◽  
Node Biopsy

ObjectiveA retrospective cohort study comparing survival and perioperative outcomes of patients with early vulvar cancer who underwent sentinel lymph node biopsy versus standard lymphadenectomyMethodsPatients diagnosed between January 2012 and December 2015 with vulvar squamous cell carcinoma of less than 4 cm in size, with invasion of at least 1 mm, who underwent sentinel lymph node biopsy, lymphadenectomy, or both were identified from the National Cancer Database. Overall survival was evaluated following generation of Kaplan-Meier curves and compared with the log-rank test for patients who had at least 1 month of follow-up. A Cox model was constructed to control for confounders.ResultsA total of 1583 patients were identified; 304 patients (19.2%) underwent sentinel lymph node biopsy alone. Sentinel lymph node biopsy utilization increased 13.9% between 2012 and 2015. Patients who underwent sentinel node biopsy alone were less likely to have comorbidities compared with those undergoing lymphadenectomy only or sentinel node biopsy with lymphadenectomy (25.3% vs 32.9% vs 31.9%, p=0.042), had smaller tumors (median 1.6 vs 2.0 vs 2.0 cm, p<0.001), and were less likely to have positive lymph nodes (11% vs 19.6% vs 28.1%, p<0.001). There was no difference in 3 year overall survival between the three groups (86.3% vs 82.1% vs 77.9%, p=0.26). After controlling for age, race, insurance, comorbidities, lymph node metastases, and tumor size, sentinel lymph node biopsy alone was not associated with worse overall survival compared with lymphadenectomy (HR 0.86, 95% CI 0.57 to 1.32). The sentinel node only group had shorter inpatient stays compared with lymphadenectomy only (median 1 vs 2 days, p<0.001) and a lower rate of unplanned readmission (1.7% vs 5.0%, p=0.010).ConclusionsThe utilization of sentinel lymph node biopsy is increasing in the management of vulvar cancer and is associated with superior perioperative outcomes without impacting overall survival.

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