A Comparison of Sentinel Lymph Node Biopsy to Lymphadenectomy for Endometrial Cancer Staging (FIRES Trial): A Multicentre, Prospective, Cohort Study

Rossi, Emma; Kowalski, Lynn D.; Scalici, Jennifer; Cantrell, Leigh A.; Schuler, Kevin; Hanna, Rabbie K.; Method, Michael; Ade, Melissa; Ivanova, Anastasia; Boggess, John F.

doi:10.1097/ogx.0000000000000467

Cited by 69 publications

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“…The relevant literature has reported that low- and high-risk factors for pelvic lymph-node metastasis were 1.4–3% and 6.4–23%, respectively [ 2 , 11 ]. The SLN detection in the abdominal aorta was less than 5% [ 19 ]. In addition, the probability that SLN had an abdominal aortic lymph-node transfer was low at 0.8–1%, with a 3% chance of metastatic EC in high-risk patients [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

A retrospective validation study of sentinel lymph node mapping for high-risk endometrial cancer

Sun

et al. 2019

Arch Gynecol Obstet

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Objectives To determine the feasibility and performance of sentinel lymph-node (SLN) mapping among women with high-risk endometrial cancer (EC). Materials and methods Ninety-eight patients at high-risk EC were enrolled in this retrospective surgical trial from August 2016 to August 2018. All patients underwent intraoperative SLN biopsy, with ICG injection for laparoscopic staging; this was followed by pelvic and paraaortic lymphadenectomy (LAD). Outcomes included SLN detection rate, false-negative SLN algorithm rate, and the negative predictive value (NPV) of the SLN algorithm. The Chi-square test was used to analyze the relationship between SLN mapping and the risk factors. Then, we performed Kappa consistency check ( P < 0.05 with Meaning), to estimate the consistency of SLN and lymph-node metastasis. Results Successful biopsy occurred in 94 patients (170 sides) among 98 patients (196 sides). At least 1 SLN was identified in 86.7% (170/196). Overall, the false-negative rate (FNR) was 11.8% (2/17), NPV was 97.3% (72/74), and sensitivity was 88.2% (15/17). 22/98 patients (22.4%) with high-risk EC had at least one metastatic lymph node identified. When the SLN algorithm was retrospectively applied, the FNR was 9.1% (2/22) and sensitivity was 90.9% (20/22). Considering the surgeon’s experience, 68 cases of EC (except for 30 patients), the detection rate was 89.7% (122/136), NPV was 98.1% (50/51), and the FNR was 5.6% (1/18). The factor significantly affecting the detection rate of SLNs was lymphovascular space invasion (LVSI) ( P = 0.016). SLN metastasis of EC was associated with depth of myometrial invasion ( P = 0.034). The analysis result of SLN and the consistency of pelvic lymph-node metastasis status. As detected by Kappa coefficient was 0.939 ( P < 0.001), suggests highly consistency. Conclusions Our SLN detection rate for high-risk EC was the same as previously reported. When SLN is not detected, better after 30 patients’ experience, is a reasonable alternative to complete LAD in high-risk EC. In addition, SLN shows high co-occurrence with pelvic lymph nodes. Therefore, SLN biopsy can be used to diagnose high-risk EC.

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Section: Discussionmentioning

confidence: 99%

A retrospective validation study of sentinel lymph node mapping for high-risk endometrial cancer

Sun

et al. 2019

Arch Gynecol Obstet

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“…The prevalence of lymphedema in the legs was significantly lower after sentinel lymph node mapping as compared to full lymphadenectomy (1.3% vs. 18.1%; p < 0.001) [43]. As mentioned earlier, the FIRES test reports sentinel lymph node mapping sensitivity is higher than 95% [38]. Recently, 2 comparative studies were conducted between two referral centers, the Mayo Clinic (Rochester, MN, USA) and the Memorial Sloan Kettering Cancer Center (New York, USA) [41] [44].…”

Section: Methodsmentioning

confidence: 60%

“…At the Mayo Clinic, total pelvic and para-aortic lymphadenectomy was performed in specific cases considered to have a risk of nodal metastasis (FIGO grade 3 and/or primary tumor diameter > 2 cm) [44]. Increasing evidence indicated that sentinel lymph node mapping does not affect the outcomes as compared to patients with full node dissection [38] [44] [45]. Buda et al confirmed data and reported higher prevalence of positive lymph nodes in-patient undergoing sentinel lymph node mapping as compared to conventional lymph node dissection group (16.7% and 7.3% of patients with positive pelvic lymph nodes, in sentinel node mapping and lymphadenectomy groups respectively; p = 0.002) [46].…”

Section: Methodsmentioning

confidence: 99%

“…Macrometastasis is defined as the tumor cells in clusters and/or lymph nodes larger than 2 mm; the micrometastases are microscopic clusters and single cells measuring between >0.2 mm to ≤2 mm; the isolated tumor cells are microscopic clusters, and single cells ≤ 0.2 mm. In various studies on this issue, the presence of small-volume lymphatic diseases ranges from 25% to 63% [38] [50] [51] [52]. Recently, Plante et al [49] a total of 519 patients with sentinel lymph node mapping was evaluated, of which 85 were diagnosed with lymphatic disease.…”

Section: Methodsmentioning

confidence: 99%

“…Based on these numbers, the sensitivity of detecting lymph node-positive disease is 97.2%, and the negative predictive value is 99.6%[38]. Soliman reported the overall SLN detection rate and bilateral detection rate was 89% and 58% respectively…”

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confidence: 98%

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Current Role and Benefits of Sentinel Lymph Node Mapping in Endometrial Cancer

Sugandha¹,

Shen²,

Prayes³

et al. 2020

OJOG

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Endometrial cancer (EC) is one of the three major malignant tumors of the female reproductive system in developed countries. In recent years, the incidence of EC ranks first in gynecological malignancy and the mainstay of treatment is Surgery. Although EC has a high prevalence, its several features associated with management are still unclear. Endometrial cancer lymph node status is the most important predictor of survival and also guides postoperative treatment planning but in gynecologic oncology, lymphadenectomy, as a part of initial surgical management remains controversial. The current introduction of sentinel lymph node mapping in EC patients represents a midway between the execution and omission of node dissection. Sentinel lymph node (SLN) mapping has emerged as an alternative staging strategy hence, the role of SLN mapping is currently being evaluated prospectively in several centers. The objective of this review is to provide an update of the emerging role of sentinel node mapping in EC. In this review, we discussed how several different techniques, type of tracers utilized and injection sites has been described and used for lymphatic mapping in EC impacting on sentinel lymph node detection rates. In addition, we also discussed another evolving field in EC staging i.e. interpretation of pathologic ultra staging of SLN, which can identify low volume metastasis for which the clinical significance and ideal management remain uncertain. Future perspective regarding EC management is also discussed in this review.

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Role of sentinel lymph node biopsy for oral squamous cell carcinoma: Current evidence and future challenges

et al. 2022

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Sentinel lymph node biopsy (SLNB) has been used across oncological specialties for prognostication, staging, and identification of occult nodal metastasis. Recent studies demonstrated the potential clinical utility of SLNB in oral cavity squamous cell carcinoma (OCSCC). Elective neck dissection is the current standard of care in early management of OCSCC with depth of invasion greater than 2-4 mm; however, majority of patients ultimately do not have nodal disease on final pathology. SLNB is an alternative procedure widely adopted in early cancer management in many oncological subspecialities. Several considerations such as depth of invasion, nodal mapping, histopathology methods, operator variability, postoperative complications, and advancement in preoperative and intraoperative imaging technology can guide the appropriate application to SLNB in OCSCC. The aim of this review is to discuss the current evidence for SLNB in the treatment of early stage OCSCC, imaging technologies that support SLNB procedures, and studies that are currently underway.

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A Comparison of Sentinel Lymph Node Biopsy to Lymphadenectomy for Endometrial Cancer Staging (FIRES Trial): A Multicentre, Prospective, Cohort Study

Abstract: (Abstracted from Lancet Oncol 2017;18:384–392) In more than 75% of women with endometrial cancer, the disease is confined to the uterus. Recurrence risk is defined by surgical staging with lymphadenectomy and helps in the decision to give adjuvant treatment to high-risk patients.

Cited by 69 publications

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A retrospective validation study of sentinel lymph node mapping for high-risk endometrial cancer

A retrospective validation study of sentinel lymph node mapping for high-risk endometrial cancer

Current Role and Benefits of Sentinel Lymph Node Mapping in Endometrial Cancer

Role of sentinel lymph node biopsy for oral squamous cell carcinoma: Current evidence and future challenges

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