A systematic review of tests for lymph node status in primary endometrial cancer

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.

Download Full-text

Dkk3 Wnt inhibitor expression in endometrial cancer predicts pelvic lymph node status, and correlates with clinicopathologic factors

Gynecologic Oncology ◽

10.1016/j.ygyno.2012.07.056 ◽

2012 ◽

Vol 127 (1) ◽

pp. S20 ◽

Cited By ~ 1

Author(s):

T. Dellinger ◽

K. Planutis ◽

B. Monk ◽

R. Holcombe

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

Pelvic Lymph Node ◽

Lymph Node Status ◽

Node Status ◽

Wnt Inhibitor ◽

Clinicopathologic Factors

Download Full-text

Preoperative CT or PET/CT to Assess Pelvic and Para-Aortic Lymph Node Status in Epithelial Ovarian Cancer? A Systematic Review and Meta-Analysis

Diagnostics ◽

10.3390/diagnostics11101748 ◽

2021 ◽

Vol 11 (10) ◽

pp. 1748

Author(s):

Camille Mimoun ◽

Roman Rouzier ◽

Jean Louis Benifla ◽

Arnaud Fauconnier ◽

Cyrille Huchon

Keyword(s):

Systematic Review ◽

Ovarian Cancer ◽

Lymph Node ◽

Diagnostic Accuracy ◽

Epithelial Ovarian Cancer ◽

Meta Analysis ◽

Lymph Node Status ◽

Node Status ◽

Pet Ct ◽

Preoperative Ct

Background: In advanced epithelial ovarian cancer (EOC), the LION trial restricted lymphadenectomy indication to patients with suspect lymph nodes before and during surgery. Preoperative imaging is used to assess lymph node status, and particularly CT and PET/CT. The aim of this systematic review and meta-analysis was to evaluate the diagnostic accuracy of preoperative CT and PET/CT to detect lymph node metastasis (LNM) in patients with EOC; Methods: Databases were searched from January 1990 to May 2019 for studies that evaluated the diagnostic accuracy of preoperative CT and PET/CT to detect LNM in patients with EOC with histology as the gold standard. Pooled diagnostic accuracy was calculated using bivariate random-effects models and hierarchical summary receiver operating curve (HSROC). This study is registered with PROSPERO number CRD42020179214; Results: A total of five studies were included in the meta-analysis: four articles concerned preoperative CT and four articles concerned preoperative PET/CT, involving 106 and 138 patients, respectively. For preoperative CT, pooled sensitivity was 0.47 95% CI [0.20–0.76], pooled specificity was 0.99 95% CI [0.75–1.00] and area under the curve (AUC) of the HSROC was 0.91 95% CI [0.88–0.93]. For preoperative PET/CT, pooled sensitivity was 0.81 95% CI [0.61–0.92], pooled specificity was 0.96 95% CI [0.91–0.99] and AUC of the HSROC was 0.97 95% CI [0.95–0.98]; Conclusions: PET/CT has a very high diagnostic accuracy, especially for specificity, to detect LNM in EOC and should be realized systematically, additionally to CT recommended to evaluate peritoneal spread, in the preoperative staging of patients with an advanced disease.

Download Full-text

Evaluation of lymph node status in patients with urothelial carcinoma—still in search of the perfect imaging modality: a systematic review

Translational Andrology and Urology ◽

10.21037/tau.2018.08.28 ◽

2018 ◽

Vol 7 (5) ◽

pp. 783-803 ◽

Cited By ~ 1

Author(s):

Michał Frączek ◽

Hubert Kamecki ◽

Anna Kamecka ◽

Roman Sosnowski ◽

Katarzyna Sklinda ◽

...

Keyword(s):

Systematic Review ◽

Lymph Node ◽

Urothelial Carcinoma ◽

Imaging Modality ◽

Lymph Node Status ◽

Node Status

Download Full-text

Relationship of lymph node status with survival and recurrence among women with endometrial cancer

International Journal of Gynecology & Obstetrics ◽

10.1002/ijgo.13309 ◽

2020 ◽

Vol 151 (2) ◽

pp. 267-271

Author(s):

Osman Cagin Buldukoglu ◽

Alev Turker ◽

Alp Usubutun ◽

Mehmet Coskun Salman

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

Lymph Node Status ◽

Node Status ◽

Relationship Of

Download Full-text

Faculty Opinions recommendation of Association of Histologic Regression in Primary Melanoma With Sentinel Lymph Node Status: A Systematic Review and Meta-analysis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725765191.793511378 ◽

2015 ◽

Author(s):

Eduardo Calonje ◽

Jose Cardoso

Keyword(s):

Systematic Review ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Meta Analysis ◽

Primary Melanoma ◽

Lymph Node Status ◽

Node Status ◽

Sentinel Lymph Node Status

Download Full-text

Lymph Node Status Did Not Significantly Improve the Predictability of Survival in Patients With Clinically Early-Stage Endometrial Cancer

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000237 ◽

2014 ◽

Vol 24 (8) ◽

pp. 1449-1454

Author(s):

Hyo Sook Bae ◽

Jong-Min Lee ◽

Jae-Kwan Lee ◽

Jae-Weon Kim ◽

Chi-Heum Cho ◽

...

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

Early Stage ◽

Lymph Node Status ◽

Survival Prediction ◽

Concordance Index ◽

Node Metastasis ◽

Node Status ◽

Early Stage Endometrial Cancer ◽

Cause Specific Survival

ObjectiveThe aim of this study was to determine whether knowledge of lymph node status improves survival prediction in clinically early-stage endometrial cancer.MethodsThe records of 661 patients with apparently uterine-confined disease were reviewed. The performance in predicting overall survival and cause-specific survival was compared between a multivariate prognostic model with nodal status and a model without nodal status by calculating Harrell concordance index.ResultsAmong 661 patients with clinically early-stage endometrial cancer, the lymph node metastasis rate was 8.3% (55/661). Lymph node metastasis independently associated with cause-specific survival only when no stratification according to adjuvant treatment was applied (P= 0.035). After stratification according to adjuvant radiotherapy, lymph node status marginally associated with cause-specific survival (P =0.073), whereas myometrial invasion retained its strong association with cause-specific survival (P< 0.001). However, there was no significant difference in the performance of the survival model using only uterine factors and the model using lymph node status and uterine factors (concordance index, 0.77 vs 0.77, respectively;P= 0.798).ConclusionsKnowledge of lymph node status did not significantly improve the performance of survival prediction in apparently uterine-confined endometrial cancer, although it was independently associated with survival. In the patients with clinically early-stage endometrial cancer, the accuracy of the prediction of survival was comparable between risk grouping without lymph node status and that including lymph node status.

Download Full-text

Is postoperative chemotherapy necessary for resected esophageal carcinoma after neoadjuvant chemoradiotherapy? A systematic review and meta-analysis

10.21203/rs.3.rs-27013/v1 ◽

2020 ◽

Author(s):

Liang Cheng ◽

Wei Gao ◽

Hao Yang ◽

Yu Zhou ◽

Yongsheng Zhao ◽

...

Keyword(s):

Systematic Review ◽

Lymph Node ◽

Esophageal Carcinoma ◽

Meta Analysis ◽

Neoadjuvant Chemoradiotherapy ◽

Postoperative Chemotherapy ◽

Sensitivity Analyses ◽

Cochrane Library ◽

Lymph Node Status ◽

Node Status

Abstract Background Both neoadjuvant chemoradiotherapy (NCRT) and postoperative chemotherapy (PT) are crucial treatments for esophageal carcinoma (EC). However, it is not clear whether PT is required for EC treatment after NCRT. This systematic review and meta-analysis aimed at clarifying the necessity of PT for resected EC after NCRT.Methods We searched PubMed, Embase, and The Cochrane Library databases for relevant studies published up to March 2020, that have compared PT and non-PT for resected EC after NCRT (NCRT + PT vs. NCRT). The primary outcome of this study was overall survival (OS). Hazard risk ratio (HR) and 95% confidence interval (CI) were calculated. Subgroup and sensitivity analyses were employed to explore heterogeneity, and the random effect model was used to merge the meta-analysis data, regardless of whether the heterogeneity was large or small.Results This study included seven retrospective cohorts, with more than 10720 patients. Most of the patients had esophageal adenocarcinomas. The Meta-analysis showed that NCRT followed by PT increased the patient OS (HR = 0.79, 95% CI 0.74–0.85, P < 0.001). However, further subgroup analysis showed that NCRT + PT might not improve the OS of resected EC patients with a negative lymph node status (HR = 0.82, 95% CI 0.67–1.01, P = 0.124). Further, we showed that NCRT with PT improved the survival of EC patients with a positive lymph node status who underwent resection (HR = 0.78, 95% CI 0.70–0.86, P < 0.001).Conclusion PT may improve the survival of lymph node-positive EC patients previously treated by NCRT. This conclusion may be more applicable to EAC patients treated with NCRT at the ypN + stage.

Download Full-text