Oncologic impact of micrometastases or isolated tumor cells in sentinel lymph nodes of patients with endometrial cancer: a meta-analysis

Gómez-Hidalgo, Natalia R; Ramírez, Pedro T.; Ngo, Brian; Pérez‐Hoyos, S.; Coreas, Noemy; Sánchez-Iglesias, José Luís; Cabrera, Sílvia; Franco, Silvia; Benavente, A P; Gil‐Moreno, Antonio

doi:10.1007/s12094-019-02249-x

Cited by 37 publications

(34 citation statements)

References 27 publications

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“…No macrometastases were identified in this group. There is currently a gap in knowledge regarding the significance of micrometastases found in the sentinel nodes of patients with EC 22 . Although there is an increased relative risk of recurrence with low‐volume metastases, whether adjuvant treatment is indicated based on micrometastatic nodal disease alone remains a topic of debate as often there are other uterine factors implicated in the prognosis 22 .…”

Section: Discussionmentioning

confidence: 99%

“…There is currently a gap in knowledge regarding the significance of micrometastases found in the sentinel nodes of patients with EC 22 . Although there is an increased relative risk of recurrence with low‐volume metastases, whether adjuvant treatment is indicated based on micrometastatic nodal disease alone remains a topic of debate as often there are other uterine factors implicated in the prognosis 22 . This study is underpowered to fully establish the role of HE4 as a predictor of nodal disease, and further studies are required to establish the relationship between serum HE4 level and metastatic nodal disease in EC, especially with the development of a sentinel lymph node paradigm.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic value of serum HE4 level in the management of endometrial cancer: A pilot study

Rajadevan

McNally

Neesham

et al. 2021

Aust NZ J Obst Gynaeco

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Background Human epididymis protein 4 (HE4) has shown promising utility as a prognostic biomarker in endometrial cancer. Increased serum HE4 levels may be associated with deeper myometrial invasion, extrauterine disease and poorer prognosis. Aim To evaluate the use of serum HE4 level, compared to and alongside other investigations, to accurately guide management in apparent early‐stage endometrial cancer. Materials and Methods This is a single‐site prospective study of 100 patients with histologically confirmed endometrial cancer. All patients underwent preoperative measurements of HE4 and CA125 levels and a preoperative magnetic resonance imaging (MRI) to assess the depth of invasion, nodal status and tumour size. Correlation was sought between serum HE4 level, CA125 level, MRI findings and intra‐operative frozen section with tumour type, grade and stage. Results While both median HE4 and CA125 levels were higher with worsening clinicopathological features, serum HE4 level showed a more consistent association with high‐risk features. Patients with a low‐grade biopsy preoperatively and a low HE4 level (<70 pmol/L) demonstrated an 86.8% likelihood of having low‐risk disease on final histopathology. In comparison, preoperative MRI or intraoperative frozen section alongside a low‐grade biopsy demonstrated a similar likelihood of 86.2 and 87.7%, respectively. Conclusions When used in conjunction with an initial low‐grade endometrial biopsy, serum HE4 level demonstrated a similar likelihood to both preoperative MRI and intraoperative frozen section in identifying low‐risk disease on final histopathology. As a triaging tool this may be significant given that a preoperative, serum‐based assay would likely be the least invasive, least resource‐intensive and most cost‐effective approach.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prognostic value of serum HE4 level in the management of endometrial cancer: A pilot study

Rajadevan

McNally

Neesham

et al. 2021

Aust NZ J Obst Gynaeco

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“…Lygintos dvi grupės: I grupę sudarė pacientės, kurioms nustatytos INL/ MM, adjuvantinis gydymas neskirtas, II grupę sudarė pacientės, kurioms nustatyti neigiami limfmazgiai arba kurioms nustatytos INL/MM ir skirtas adjuvantinis gydymas. Ligos atkryčio rizika buvo vienoda abiejose grupėse [27].…”

Section: Rezultataiunclassified

Minimally Invasive Surgery and Sentinel Lymph Node Biopsy – a Modern Standart of Uterine Confined Endometrial Cancer Treatment: Reviewing Literature and Presenting the National Cancer Institute Experience

Čiurlienė

Žilovič

Romeikienė

et al. 2020

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Objectives. To find out sentinel lymph node detection rate of low-risk endometrial cancer patients. To compare postoperative complications rate, lenght of a surgery, lenght of hospital stay and sensitivity of detecting lymph node metastasis between minimally invasive surgery with sentinel lymph node biopsy and abdominal surgery with systemic pelvic lymphadenectomy. Methods. Retrospective analysis of low-risk endometrial cancer patients, treated in National Cancer Institute (n = 103) history cases from 2018 10 untill 2019 12. I group – laparoscopic hysterectomy with sentinel lymph node biopsy (n = 35); II group – abdominal hysterectomy with systemic pelvic lymphadenectomy (n = 68). Both groups were homogeneous according to clinicopathological features. Results. Sentinel lymph node were detected in 97.1% cases. Sentinel lymph nodes in both sides were detected in 85.7% cases. Metastasis in regional lymph nodes were detected in 2 cases (5.7%) in group I and none group II. Postoperative complications rate in group I were 3.8% and 13% in group II. Conclusions. There are significantly less postoperative complications in endoscopic surgery with sentinel node biopsy for low-risk endometrial cancer treatment, also this method is more accurate in surgical staging in National Cancer Institute.

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“…The impact of ITCs on prognosis is a topic of ongoing discussion. MICs lead to a significantly worse prognosis and are considered as pN+ disease (lymph node metastases) and therefore lead to an increased rate of adjuvant treatment as a result of SLN [ 19 , 20 , 21 , 22 , 23 ]. These results were underlined by the FIRES trial.…”

Section: Introductionmentioning

confidence: 99%

“…This should lead to rethinking a target volume definition for radiation [ 24 ]. However, despite more frequent use of adjuvant therapy following sentinel concept, a survival benefit has not yet been demonstrated until now [ 19 , 20 , 21 , 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

A Modern Approach to Endometrial Carcinoma: Will Molecular Classification Improve Precision Medicine in the Future?

Marnitz

Walter

Schömig-Markiefka

et al. 2020

Cancers

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Endometrial cancer has been histologically classified as either an estrogen-dependent cancer with a favorable outcome or an estrogen-independent cancer with a worse prognosis. These parameters, along with the clinical attributions, have been the basis for risk stratification. Recent molecular and histopathological findings have suggested a more complex approach to risk stratification. Findings from the Cancer Genome Atlas Research Network established four distinctive genomic groups: ultramutated, hypermutated, copy-number low and copy-number high prognostic subtypes. Subsequently, more molecular and histopathologic classifiers were evaluated for their prognostic and predictive value. The impact of molecular classification is evident and will be recognized by the upcoming WHO classification. Further research is needed to give rise to a new era of molecular-based endometrial carcinoma patient care.

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Oncologic impact of micrometastases or isolated tumor cells in sentinel lymph nodes of patients with endometrial cancer: a meta-analysis

Cited by 37 publications

References 27 publications

Prognostic value of serum HE4 level in the management of endometrial cancer: A pilot study

Prognostic value of serum HE4 level in the management of endometrial cancer: A pilot study

Minimally Invasive Surgery and Sentinel Lymph Node Biopsy – a Modern Standart of Uterine Confined Endometrial Cancer Treatment: Reviewing Literature and Presenting the National Cancer Institute Experience

A Modern Approach to Endometrial Carcinoma: Will Molecular Classification Improve Precision Medicine in the Future?

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