Sentinel Lymph Node Biopsy in Endometrial Cancer: a New Standard of Care?

被引:23
作者
Sullivan, Stephanie A. [1 ]
Rossi, Emma C. [1 ]
机构
[1] Univ North Carolina Chapel Hill, Div Gynecol Oncol, Dept Obstet & Gynecol, CB 7572,Phys Off Bldg, Chapel Hill, NC 27599 USA
关键词
Endometrial cancer; Sentinel lymph nodes; ICG I Lymphedema; Lymphadenectomy; FIRES; EARLY-STAGE ENDOMETRIAL; GYNECOLOGIC-ONCOLOGY-GROUP; INDOCYANINE GREEN; HYSTEROSCOPIC INJECTION; PELVIC LYMPHADENECTOMY; RISK-FACTORS; CARCINOMA; IMPACT; MULTICENTER; METASTASIS;
D O I
10.1007/s11864-017-0503-z
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Lymph node status is one of the most important factors in determining prognosis and the need for adjuvant treatment in endometrial cancer (EMCA). Unfortunately, full lymphadenectomy bears significant surgical and postoperative risks. The majority of patients with clinical stage I disease will not have metastatic disease; thus, a full lymphadenectomy only increases morbidity in this population of patients. The use of the sentinel lymph node (SLN) biopsy has emerged as an alternative to complete lymphadenectomy in EMCA. By removing the highest yield lymph nodes, the SLN biopsy has the same diagnostic ability as lymphadenectomy while minimizing morbidity. The sensitivity of sentinel lymph node identification with robotic fluorescence imaging for detecting metastatic endometrial and cervical cancer (FIRES) trial published this year is the largest prospective, multi-institution trial investigating the accuracy of the SLN biopsy for endometrial and cervical cancer. Results of this trial found an excellent sensitivity (97.2%) and false negative rate (3%) with the technique. The conclusions from the FIRES trial and those of a recent meta-analysis are that SLN biopsy has an acceptable diagnostic accuracy in detecting lymphatic metastases, and can replace lymphadenectomy for this diagnostic purpose. There remains controversy surrounding the SLN biopsy in high- risk disease and the use of adjuvant therapy in the setting of low volume disease detected with ultrastaging. Current data suggests that the technique is accurate in high-risk disease and that the increased detection of metastasis helps guide adjuvant therapy such that oncologic outcomes are likely not affected by forgoing a full lymphadenectomy. Further prospective study is needed to investigate the impact of low volume metastatic disease on oncologic outcomes and the need for adjuvant therapy in these patients.
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页数:12
相关论文
共 51 条
[1]   Sentinel Lymph Node Mapping for Endometrial Cancer: A Modern Approach to Surgical Staging [J].
Abu-Rustum, Nadeem R. .
JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK, 2014, 12 (02) :288-297
[2]   Morbidity of pelvic lymphadenectomy and para-aortic lymphadenectomy in endometrial cancer [J].
Agar, Nicolas ;
Philippe, Anne-Cecile ;
Bourdel, Nicolas ;
Rabischong, Benoit ;
Canis, Michel ;
Le Bouedec, Guillaume ;
Mulliez, Aurelien ;
Dauplat, Jacques ;
Pomel, Christophe .
BULLETIN DU CANCER, 2015, 102 (05) :428-435
[3]  
[Anonymous], 2010, AJCC CANC STAGING MA, P347
[4]   Detection rate and diagnostic accuracy of sentinel-node biopsy in early stage endometrial cancer: a prospective multicentre study (SENTI-ENDO) [J].
Ballester, Marcos ;
Dubernard, Gil ;
Lecuru, Fabrice ;
Heitz, Denis ;
Mathevet, Patrice ;
Marret, Henri ;
Querleu, Denis ;
Golfier, Francois ;
Leblanc, Eric ;
Rouzier, Roman ;
Darai, Emile .
LANCET ONCOLOGY, 2011, 12 (05) :469-476
[5]   The importance of applying a sentinel lymph node mapping algorithm in endometrial cancer staging: Beyond removal of blue nodes [J].
Barlin, Joyce N. ;
Khoury-Collado, Fady ;
Kim, Christine H. ;
Leitao, Mario M., Jr. ;
Chi, Dennis S. ;
Sonoda, Yukio ;
Alektiar, Kaled ;
DeLair, Deborah F. ;
Barakat, Richard R. ;
Abu-Rustum, Nadeem R. .
GYNECOLOGIC ONCOLOGY, 2012, 125 (03) :531-535
[6]   Incidence, risk factors and estimates of a woman's risk of developing secondary lower limb lymphedema and lymphedema-specific supportive care needs in women treated for endometrial cancer [J].
Beesley, Vanessa L. ;
Rowlands, Ingrid J. ;
Hayes, Sandi C. ;
Janda, Monika ;
O'Rourke, Peter ;
Marquart, Louise ;
Quinn, Michael A. ;
Spurdle, Amanda B. ;
Obermair, Andreas ;
Brand, Alison ;
Oehler, Martin K. ;
Leung, Yee ;
McQuire, Lesley ;
Webb, Penelope M. .
GYNECOLOGIC ONCOLOGY, 2015, 136 (01) :87-93
[7]   Impact of Indocyanine Green for Sentinel Lymph Node Mapping in Early Stage Endometrial and Cervical Cancer: Comparison with Conventional Radiotracer 99mTc and/or Blue Dye [J].
Buda, Alessandro ;
Crivellaro, Cinzia ;
Elisei, Federica ;
Di Martino, Giampaolo ;
Guerra, Luca ;
De Ponti, Elena ;
Cuzzocrea, Marco ;
Giuliani, Daniela ;
Sina, Federica ;
Magni, Sonia ;
Landoni, Claudio ;
Milani, Rodolfo .
ANNALS OF SURGICAL ONCOLOGY, 2016, 23 (07) :2183-2191
[8]   Sentinel Lymph Node Mapping With Near-Infrared Fluorescent Imaging Using Indocyanine Green: A New Tool for Laparoscopic Platform in Patients With Endometrial and Cervical Cancer [J].
Buda, Alessandro ;
Bussi, Beatrice ;
Di Martino, Giampaolo ;
Di Lorenzo, Paolo ;
Palazzi, Sharon ;
Grassi, Tommaso ;
Milani, Rodolfo .
JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY, 2016, 23 (02) :265-269
[9]   To what extent is risk grouping method successful in deciding surgical staging in endometrial cancer? [J].
Cetinkaya, Kadir ;
Atalay, Funda ;
Bacinoglu, Ahmet ;
Dervisoglu, Haluk .
TUMORI JOURNAL, 2016, 102 (04) :422-425
[10]   Therapeutic role of lymph node resection in endometrioid corpus cancer - A study of 12,333 patients [J].
Chan, John K. ;
Cheung, Michael K. ;
Huh, Warner K. ;
Osann, Kathryn ;
Husain, Amreen ;
Teng, Nelson N. ;
Kapp, Daniel S. .
CANCER, 2006, 107 (08) :1823-1830