Oncologic outcomes of endometrial cancer in patients with low-volume metastasis in the sentinel lymph nodes: An international multi-institutional study

Ghoniem, Khaled; Larish, Alyssa; Dinoi, Giorgia; Zhou, Xun; AlHilli, Mariam M.; Wallace, S.; Wohlmuth, Christoph; Baiocchi, Glauco; Tokgözoğlu, Nedim; Raspagliesi, Francesco; Buda, Alessandro; Zanagnolo, Vanna; Zapardiel, Ignacio; Jagasia, Nisha; Giuntoli, Robert L.; Glickman, Ariel; Peiretti, Michele; Lanner, Maximillian; Chacón, Enrique; Guilmi, Julián Di; Pereira, Augusto; Laas, Enora; Fishman, Ami; Nitschmann, Caroline C.; Parker, Susan; Joehlin‐Price, Amy; Lees, Brittany; Covens, Allan; Brot, Louise De; Taşkiran, Ç.; Bogani, Giorgio; Paniga, Cristiana; Multinu, Francesco; Hernandez-Gutierrez, Alicia; Weaver, Amy L.; McGree, Michaela E.; Mariani, Andrea

doi:10.1016/j.ygyno.2021.06.031

Cited by 37 publications

(47 citation statements)

References 24 publications

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“…The National Comprehensive Cancer Network and Japan Society of Gynecologic Oncology Guidelines recommend performing intraoperative peritoneal ascites cytology, while Matsuo et al warn that the European Society of Medical Oncology, European Society of Gynaecological Oncology, and European Society for Radiotherapy and Oncology do not mandate performing peritoneal cytology because positive peritoneal cytology is excluded from the staging system when determining advanced stages of endometrial cancer [ 13 , 14 ]. In addition, several recent clinical trials for endometrial cancer included positive ascites cytology as a risk factor [ 13 , 15 , 16 ]. Thus, other investigators believe that peritoneal cytology may be an important risk factor [ 13 , 15 , 16 ], and further studies are needed to elucidate this aspect.…”

Section: Discussionmentioning

confidence: 99%

Suspicious Positive Peritoneal Cytology (Class III) in Endometrial Cancer Does Not Affect Prognosis

Sone

Suzuki

Taguchi

et al. 2022

JCM

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Positive peritoneal cytology is a poor prognostic factor in patients with advanced endometrial cancer. Suspicious positive peritoneal cytology (class III) is commonly encountered in clinical practice. However, no standard treatment protocol exists for its management. Here, we investigated a possible relationship between suspicious positive peritoneal cytology, disease stage, risk factors, and endometrial cancer prognosis. We included patients diagnosed with endometrial cancer who underwent total hysterectomy and peritoneal cytology at the University of Tokyo Hospital between 2008 and 2022. Overall, 670 patients were included in the analyses; both demographic and clinical data of the patients were collected. The proportion of patients with lymph node metastasis was significantly different between peritoneal cytology groups, showing lymph node metastasis to be more extensive in patients with positive or suspicious positive peritoneal cytology than in patients with negative peritoneal cytology (p < 0.05). Thirty-nine patients had suspicious positive peritoneal cytology. Omental resection and biopsy were performed in 16 cases. No case of omental metastasis was found. Among patients with suspected ascites cytology, no patient experienced symptom recurrence or death. Therefore, monitoring lymph node metastasis in suspicious positive cases is essential. Moreover, a change of treatment method based on the finding of suspected positive peritoneal cytology is not necessary.

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Section: Discussionmentioning

confidence: 99%

Suspicious Positive Peritoneal Cytology (Class III) in Endometrial Cancer Does Not Affect Prognosis

Sone

Suzuki

Taguchi

et al. 2022

JCM

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“…Interestingly, those experiences suggested that the prevalence of micrometastasis and isolated tumor cells correlates with pathological characteristics of the primary tumor (i.e., histology and grade). Patients with endometroid G1 endometrial cancer are more likely to be diagnosed with low volume disease in comparison to patients with endometrioid G2 and G3 endometrial cancer [26]. Moreover, the prevalence of low-volume disease in non-endometroid endometrial cancer is lower than in endometrioid counterparts [26].…”

Section: Prevalence Of Low Volume Diseasementioning

confidence: 96%

“…Accumulating evidence highlighted the importance of sentinel node mapping in detecting low-volume disease [24]. The prevalence of low volume disease ranged between different series, being approximately 50% of nodal disease [25,26]. Plante et al, in a study on this issue, reported data of 519 patients having staging surgery for endometrial cancer [25].…”

Section: Prevalence Of Low Volume Diseasementioning

confidence: 99%

“…Patients with endometroid G1 endometrial cancer are more likely to be diagnosed with low volume disease in comparison to patients with endometrioid G2 and G3 endometrial cancer [26]. Moreover, the prevalence of low-volume disease in non-endometroid endometrial cancer is lower than in endometrioid counterparts [26]. Ongoing studies are extracted by ClinicalTrials.gov [20].…”

Section: Prevalence Of Low Volume Diseasementioning

confidence: 99%

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Assessing the role of low volume disease in endometrial cancer

Bogani

Palaia

Perniola

et al. 2022

European Journal of Obstetrics & Gynecology and Reproductiv

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“…She had a pelvic node, a para-aortic node, and an adnexal metastasis, but all metastatic diseases were micrometastasis (<2 mm). Similarly, isolated tumor cells detected in removed sentinel nodes may not decrease survival, even without adjuvant therapy [ 123 , 124 , 125 , 126 ].…”

Section: Benefit Of Systematic Lymphadenectomy In Node-negative Patie...mentioning

confidence: 99%

Therapeutic Benefit of Systematic Lymphadenectomy in Node-Negative Uterine-Confined Endometrioid Endometrial Carcinoma: Omission of Adjuvant Therapy

Otsuka

2022

Cancers

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Endometrial cancer is the most common gynecological tract malignancy in developed countries, and its incidence has been increasing globally with rising obesity rates and longer life expectancy. In endometrial cancer, extrauterine disease, in particular lymph node metastasis, is an important prognostic factor. Nevertheless, pelvic lymphadenectomy is not considered to have a therapeutic benefit, as it did not improve survival in randomized studies. However, lymphadenectomy may have a therapeutic benefit if adjuvant therapy can be omitted without decreasing oncological outcomes, as the long-term quality of life is maintained by avoiding morbidities associated with adjuvant therapy. In intermediate- and high-risk endometrioid endometrial carcinomas, adjuvant therapy may be safely omitted without decreasing long-term survival by open surgery including systematic pelvic and para-aortic lymphadenectomy when patients are node-negative. Systematic lymphadenectomy may remove undetectable low-volume lymph node metastasis in both pelvic and para-aortic regions, and open surgery may reduce vaginal recurrence even without vaginal brachytherapy. However, lymphadenectomy may not improve survival in elderly patients and patients with p53-mutant tumors. In this review, I discuss the characteristics of lymph node metastasis, the methods of lymph node assessment, and the therapeutic benefits of systematic lymphadenectomy in patients with intermediate- and high-risk endometrioid endometrial carcinoma.

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Oncologic outcomes of endometrial cancer in patients with low-volume metastasis in the sentinel lymph nodes: An international multi-institutional study

Cited by 37 publications

References 24 publications

Suspicious Positive Peritoneal Cytology (Class III) in Endometrial Cancer Does Not Affect Prognosis

Suspicious Positive Peritoneal Cytology (Class III) in Endometrial Cancer Does Not Affect Prognosis

Assessing the role of low volume disease in endometrial cancer

Therapeutic Benefit of Systematic Lymphadenectomy in Node-Negative Uterine-Confined Endometrioid Endometrial Carcinoma: Omission of Adjuvant Therapy

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