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SHR Neuro Cancer Cardio Lipid Metab Microb
Bizzarri, N; Querleu, D; Ramirez, PT; Dostálek, L; van, Lonkhuijzen, LRW; Giannarelli, D; Lopez, A; Salehi, S; Ayhan, A; Kim, SH; Isla, Ortiz, D; Klat, J; Landoni, F; Pareja, R; Manchanda, R; Kosťun, J; Meydanli, MM; Odetto, D; Laky, R; Zapardiel, I; Weinberger, V; Dos, Reis, R; Pedone, Anchora, L; Amaro, K; Akilli, H; Abu-Rustum, NR; Salcedo-Hernández, RA; Javůrková, V; Mom, CH; Falconer, H; Scambia, G; Cibula, D.
Survival associated with the use of sentinel lymph node in addition to lymphadenectomy in early-stage cervical cancer treated with surgery alone: A sub-analysis of the Surveillance in Cervical CANcer (SCCAN) collaborative study.
Eur J Cancer. 2024; 211:114310
Doi: 10.1016/j.ejca.2024.114310
Web of Science
PubMed
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- Co-authors Med Uni Graz
- Laky Rene Walter
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- Abstract:
- AIM: The aim of this study was to assess whether the use of sentinel lymph node (SLN) in addition to lymphadenectomy was associated with survival benefit in patients with early-stage cervical cancer. METHODS: International, multicenter, retrospective study. INCLUSION CRITERIA: cervical cancer treated between 01/2007 and 12/2016 by surgery only; squamous cell carcinoma, adenocarcinoma, adenosquamous carcinoma, FIGO 2009 stage IB1-IIA2, negative surgical margins, and laparotomy approach. Patients undergoing neo-adjuvant and/or adjuvant treatment and/or with positive para-aortic lymph nodes, were excluded. Women with positive pelvic nodes who refused adjuvant treatment, were included. Lymph node assessment was performed by SLN (with ultrastaging protocol) plus pelvic lymphadenectomy ('SLN' group) or pelvic lymphadenectomy alone ('non-SLN' group). RESULTS: 1083 patients were included: 300 (27.7 %) in SLN and 783 (72.3 %) in non-SLN group. 77 (7.1 %) patients had recurrence (N = 11, 3.7 % SLN versus N = 66, 8.4 % non-SLN, p = 0.005) and 34 (3.1 %) (N = 4, 1.3 % SLN versus N = 30, 3.8 % non-SLN, p = 0.033) died. SLN group had better 5-year disease-free survival (DFS) (96.0 %,95 %CI:93.5-98.5 versus 92.0 %,95 %CI:90.0-94.0; p = 0.024). No 5-year overall survival (OS) difference was shown (98.4 %,95 %CI:96.8-99.9 versus 96.8 %,95 %CI:95.4-98.2; p = 0.160). SLN biopsy and lower stage were independent factors associated with improved DFS (HR:0.505,95 %CI:0.266-0.959, p = 0.037 and HR:2.703,95 %CI:1.389-5.261, p = 0.003, respectively). Incidence of pelvic central recurrences was higher in the non-SLN group (1.7 % versus 4.5 %, p = 0.039). CONCLUSION: Adding SLN biopsy to pelvic lymphadenectomy was associated with lower recurrence and death rate and improved 5-year DFS. This might be explained by the lower rate of missed nodal metastasis thanks to the use of SLN ultrastaging. SLN biopsy should be recommended in patients with early-stage cervical cancer.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Female - administration & dosage
- Uterine Cervical Neoplasms - pathology, surgery, mortality
- Lymph Node Excision - methods
- Middle Aged - administration & dosage
- Retrospective Studies - administration & dosage
- Sentinel Lymph Node - pathology, surgery
- Adult - administration & dosage
- Aged - administration & dosage
- Neoplasm Staging - administration & dosage
- Sentinel Lymph Node Biopsy - methods
- Lymphatic Metastasis - administration & dosage
- Carcinoma, Squamous Cell - surgery, pathology, mortality
- Find related publications in this database (Keywords)
- Cervical cancer
- Sentinel lymph node
- Lymphadenectomy
- Survival
- Recurrence
- Ultrastaging