Factors associated with successful bilateral sentinel lymph node mapping in endometrial cancer

Tanner, Edward J.; Sinno, Abdulrahman K.; Stone, Rebecca L.; Levinson, Kimberly; Long, K.; Fader, Amanda N.

doi:10.1016/j.ygyno.2015.06.024

Cited by 110 publications

(91 citation statements)

References 24 publications

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“…In our analysis, however, as already reported by Tanner et al [21], previous surgery on ovaries, body of the uterus, or cervix was not associated with a greater risk rate of mapping failure. Probably this is due to the total lack of patients with previous retroperitoneal surgery, as in cases of DIE, in which the surgical dissection of the parametria could possibly damage the physiological lymphatic drainage.…”

Section: Discussionsupporting

confidence: 77%

“…In our analysis, 14 factors associated with the failure of bilateral SLNs mapping (Tables 1 and 2), previously hypothesized or that were previously reported in literature [21,22], were evaluated. From the multivariate analysis, the only significant factor associated with the success of bilateral mapping was the surgeon's technical ability and experience (p = 0.003).…”

Section: Resultsmentioning

confidence: 99%

“…In the current analysis, a series of hypothetical failure's factors were evaluated that could be connected to the mapping failure [21,22]. We started by analyzing patient's characteristics aspects related to the characteristics of the patients, which could modify the physiological pelvic lymphatic drainage as previously described by Abu-Rustum et al [27] and Bodurtha Smith et al [22].…”

Section: Discussionmentioning

confidence: 99%

“…According to the current scientific literature [21,22], a correlation between tumor characteristics such as grade, histology, size, stage, or presence of LVSI and mapping failure was not identified. Similar results were reported for SLN mapping in breast cancer, where no close correlation between tumor features and mapping failure exists [34][35][36].…”

Section: Discussionmentioning

confidence: 99%

“…But what are the reasons for the methods failure? The results of the various authors are discordant about the association between obesity and lack of mapping [21,22], while there seems to be an association between bulky lymph nodes and reduced mapping due to the obstruction of the lymphatic course due to the tumor [21]. However, there is currently no definitive evidence on the factors associated with the failure of mapping with ICG in endometrial cancer.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Sentinel Lymph Node Biopsy in the Treatment of Endometrial Cancer: Why We Fail? Results of a Prospective Multicenter Study on the Factors Associated with Failure of Node Mapping with Indocyanine Green

Ianieri

Puppo²,

Novelli³

et al. 2019

Gynecol Obstet Invest

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Background: The sentinel lymph node (SLN) mapping for endometrial cancer staging is gaining wide diffusion, but there is no definitive evidence on the factors associated with the failure of mapping. Objectives: To analyze the factors associated with the possible failure of bilateral SLN mapping with indocyanine green (ICG). Methods: A prospective observational study without control on 110 patients with endometrial cancer apparently confined to the uterus, underwent laparoscopic surgical staging with SLN mapping with ICG. Results: Possible risk factors associated with bilateral mapping failure were analyzed, and a multivariate analysis was performed. The bilateral detection rate for SLNs mapping was 72.7%, whereas at least one SLN was detected in 79.1% of patients. No SLNs were identified in 6.3%. None of the patients or features related to tumor were associated with a risk of failure of the method. The only factor analyzed that was significantly associated with the success of bilateral mapping was the surgeon (p = 0.003). Conclusions: Neither obesity nor the presence of lymph node metastases was associated with mapping failure. However, there remains a need for further studies to understand all the mechanisms linked to the unsuccessful method results and to reduce the use of systematic lymphadenectomy in the case of mapping failure.

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Section: Discussionsupporting

confidence: 77%

Section: Resultsmentioning

confidence: 99%