Sentinel lymph node pathological ultrastaging: Final outcome of the Sentix prospective international study in patients with early-stage cervical cancer

被引：9

作者：

Kocian, Roman ^{[1
,2
,23
]}

Kohler, Christhardt ^{[3
]}

Bajsova, Sylva ^{[4
,23
]}

Jarkovsky, Jiri ^{[5
]}

Zapardiel, Ignacio ^{[6
]}

Di Martino, Giampaolo ^{[21
,22
]}

van Lonkhuijzen, Luc ^{[7
]}

Sehnal, Borek ^{[8
,23
]}

Sanchez, Octavio Arencibia ^{[9
]}

Gil-Ibanez, Blanca ^{[10
]}

Martinelli, Fabio ^{[11
]}

Presl, Jiri ^{[12
,23
]}

Minar, Lubos ^{[13
,23
]}

Pilka, Radovan ^{[14
,23
]}

Kascak, Peter ^{[15
,23
]}

Havelka, Pavel ^{[16
,23
]}

Michal, Martin ^{[17
,23
]}

van Gorp, Toon ^{[18
,24
]}

Nemejcova, Kristyna ^{[19
,20
]}

Dundr, Pavel ^{[19
,20
]}

Cibula, David ^{[1
,2
,23
]}

机构：

[1] Charles Univ Prague, Fac Med 1, Gynecol Oncol Ctr, Dept Gynecol Obstet & Neonatol, Prague, Czech Republic

[2] Gen Univ Hosp Prague, Prague, Czech Republic

[3] Asklepios Clin Hamburg, Dept Special Operat & Oncol Gynaecol, Hamburg, Germany

[4] Univ Hosp Ostrava, Dept Obstet & Gynecol, Ostrava, Poruba, Czech Republic

[5] Masaryk Univ, Inst Biostat & Anal, Fac Med, Brno, Czech Republic

[6] La Paz Univ Hosp, Dept Obstet & Gynecol, Madrid, Spain

[7] Acad Med Ctr, Ctr Gynecol Oncol, Amsterdam, Netherlands

[8] Charles Univ Prague, Univ Hosp Bulovka, Med Fac 1, Dept Gynecol & Obstet, Prague, Czech Republic

[9] Univ Hosp Canary Isl, Dept Gynecol Oncol, Las Palmas Gran Canaria, Spain

[10] Hosp Clin Barcelona, Inst Clin Gynecol Obstet & Neonatol ICGON, Gynecol Oncol Unit, Barcelona, Spain

[11] Fdn IRCCS Ist Nazl Tumori Milano, Dept Gynecol Oncol, Milan, Italy

[12] Charles Univ Prague, Univ Hosp Pilsen, Dept Obstet & Gynaecol, Prague, Czech Republic

[13] Masaryk Univ, Fac Med, Dept Gynecol & Obstet, Brno, Czech Republic

[14] Palacky Univ Olomouc, Univ Hosp Olomouc, Fac Med & Dent, Dept Obstet & Gynecol, Olomouc, Czech Republic

[15] Fac Hosp Trencin, Dept Obstet & Gynecol, Trencin, Slovakia

[16] KNTB As, Dept Obstet & Gynecol, Zlin, Czech Republic

[17] Hosp Ceske Budejovice, Dept Obstet & Gynaecol, JSC, Ceske Budejovice, Czech Republic

[18] Univ Hosp Leuven, Leuven Canc Inst, Dept Obstet & Gynecol, Leuven, Belgium

[19] Charles Univ Prague, Inst Pathol, Fac Med 1, Prague, Czech Republic

[20] Gen Univ Hosp, Prague, Czech Republic

[21] Humanitas San Pio X, Gynecol Oncol Surg Div, I-20159 Milan, Italy

[22] IRCCS Fdn San Gerardo Tintori, Gynecol Unit, I-20900 Monza, Italy

[23] CEEGOG, Slustice, Czech Republic

[24] BGOG, Edegem, Belgium

来源：

GYNECOLOGIC ONCOLOGY | 2024年 / 188卷

关键词：

Cervical cancer; Sentinel lymph node; Biopsy; Ultrastaging; FROZEN-SECTION EXAMINATION; FALSE-NEGATIVE RATE; MULTICENTER; METASTASES; IMPACT; TRIAL;

D O I：

10.1016/j.ygyno.2024.06.015

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objective. To report the outcome of SLN staging in the SENTIX international prospective trial of SLN biopsy in patients with cervical cancer with an intensive ultrastaging protocol and central quality control and to evaluate how the intensity of pathological assessment correlates with metastatic detection rate in SLNs. Methods. Eligible were patients with stages T1a1/LVSI+ to T1b2 (<4 cm, <= 2 cm for fertility sparing), common tumor types, no suspicious lymph nodes on imaging, and bilateral SLN detection. SLNs were examined intraoperatively , processed by an intensive protocol for ultrastaging (paraffin blocks sectioned completely in 150- mu m intervals/levels). SLNs from each site were submitted for central quality control. Results. In the SENTIX SLN study, 647 out of 733 enrolled patients underwent SLN ultrastaging, identifying 12.5% (81/647) with node positive, N1 cases. Intraoperative detection revealed metastases in 56.8% (46/81) of these cases, categorized into macrometastases (83.7%), micrometastases (26.3%) , isolated tumor cells (9.1%). Ultrastaging identified additional metastatic involvement in 43.2% (35/81) of patients, with detailed sectioning revealing metastases (MAC/MIC) at first level in 20 cases (24.7%), at levels 2 -4 in 9 cases (11.1%), and at level >= 5 in 6 cases (7.4%). Conclusion. SLN ultrastaging detects additional 43% of N1 (MAC/MIC) in patients with negative LNs by imaging and intraoperative pathological assessment. The detection rate of positive SLN correlates with the intensity (number of levels) of ultrastaging. Examination of four levels from paraffin blocks, which detects >90% of patients with N1, is a reasonable compromise for an international standard for ultrastaging. (c) 2024 Published by Elsevier Inc.

引用

页码：83 / 89

页数：7