Semiquantitative evaluation of lymph-vascular space invasion in patients affected by endometrial cancer: Prognostic and clinical implications

Restaino, Stefano; Tortorella, Lucia; Dinoi, Giorgia; Zannoni, Gianfranco; Baroni, Alessandro; Capasso, Ilaria; Distefano, E; Sozzi, Giulio; Chiàntera, Vito; Scambia, Giovanni; Fanfani, Francesco

doi:10.1016/j.ejca.2020.10.011

Cited by 33 publications

(16 citation statements)

References 24 publications

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“…These data are in accordance with the literature that shows higher rates of para-aortic metastases in non-endometrioid compared with endometrioid histologies. In addition to histological type of tumor, it is important to consider tumor size, stage, and lymphovascular space invasion, as these are significant predictors of lymph node involvement 30–33…”

Section: Discussionmentioning

confidence: 99%

Anatomical distribution of sentinel lymph nodes in patients with endometrial cancer: a multicenter study

Restaino

Buda

Puppo

et al. 2022

International Journal of Gynecological Cancer

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ObjectiveSentinel lymph node (SLN) mapping represents the standard approach in uterine confined endometrial cancer patients. The aim of this study was to evaluate the anatomical distribution of SLNs and the most frequent locations of nodal metastasis.MethodsThis was an observational retrospective multicenter study involving eight high volume gynecologic cancer centers in Italy. We reviewed 1576 patients with a histologically confirmed diagnosis of endometrial cancer from September 2015 to June 2020. All patients underwent total hysterectomy with salpingo-ophorectomy and SLN mapping.ResultsA total of 3105 SLNs were mapped and removed, 2809 (90.5%) of these were bilateral and 296 (9.5%) unilateral. The overall detection rate was 93.4% (77.9% bilateral and 15.5% unilateral). The majority of SLNs (80%) and positive SLNs (77.8%) were found at the external iliac and obturator level in both endometrioid and non-endometrioid endometrial cancer. Negative SLNs were more frequent in patients with endometrioid compared with non-endometrioid cancer (91.9% vs 86.1%, p<0.0001). Older patients, a higher body mass index, and non-endometrioid histology were more likely to have 'no mapping' (p<0.0001). Univariate and multivariate analysis showed that higher body mass index and age at surgery were independent predictive factors of empty node packet and fat tissue (p=0.029 and p<0.01, respectively).ConclusionThe most frequent sites of SLNs and metastases were located in the pelvic area below the iliac vessel bifurcation. Our findings showed that older age, a higher body mass index, and non-endometrioid histology had a negative impact on mapping.

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Section: Discussionmentioning

confidence: 99%

Anatomical distribution of sentinel lymph nodes in patients with endometrial cancer: a multicenter study

Restaino

Buda

Puppo

et al. 2022

International Journal of Gynecological Cancer

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“…Important prognostic factors are age, stage, myometrial invasion, grade, tumor type and lymphovascular space invasion (LVSI) 3 . LVSI is an independent and strong risk factor for relapse and nodal disease [4][5][6] , but it can be detected only at definitive pathological diagnosis. A new classification including LVSI was proposed in 2016 by consensus of the European Society for Medical Oncology, European Society of Gynaecological Oncology and European Society for Radiotherapy & Oncology (ESMO-ESGO-ESTRO) 3 .…”

Section: Introductionmentioning

confidence: 99%

Developing and validating ultrasound‐based radiomics models for predicting high‐risk endometrial cancer

Moro

Albanese

Boldrini

et al. 2022

Ultrasound in Obstet & Gyne

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What are the novel findings of this work?This study identified and validated radiomics features and models able to differentiate the endometrial cancer risk groups, as defined jointly by the European Society for Medical Oncology, European Society of Gynaecological Oncology and European Society for Radiotherapy & Oncology (ESMO-ESGO-ESTRO) in 2016. Radiomics seems to have some ability to discriminate low-risk endometrial cancer and better ability to discriminate high-risk endometrial cancer from other endometrial cancers, but addition of radiomics features to clinical-ultrasound models did not improve the models' performance. What are the clinical implications of this work?In clinical practice, we recommend applying the mixed (including clinical, ultrasound and radiomics features) or clinical-ultrasound models to predict high-risk endometrial cancer. In particular, patients with histology of endometrioid Grade 1-2 on preoperative biopsy and positive results when applying the models could be managed with lymphadenectomy. This is of particular relevance in cases of failure of sentinel lymph-node biopsy or for centers in which this technique is not available.

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“…Recurrences occur in approximately 20% of endometrioid (i.e., type-I histology) and 50% of non-endometrioid cases (i.e., type-II histology) [ 5 ]. The risk of developing recurrence is associated with stage, grading, tumour size, lymphovascular-space invasion (LVSI), depth of myometrial invasion, and histotype [ 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Recurrent Endometrial Cancer: Which Is the Best Treatment? Systematic Review of the Literature

Restaino

Dinoi

Fera

et al. 2022

Cancers

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Background: Endometrial cancer is the most common gynaecological tumour in developed countries. The overall rate of relapse has remained unchanged in recent decades. Recurrences occur in approximately 20% of endometrioid and 50% of non-endometrioid cases. The aim of this systematic review is to compare different therapeutic strategies in the treatment of endometrial cancer recurrence to evaluate their prognostic and curative effects based on site and type of recurrence. Methods: This systematic review of literature was conducted in accordance with the PRISMA guidelines. The study protocol was registered on PROSPERO (CRD42020154042). PubMed, Embase, Chocrane and Cinahl databases were searched from January 1995 to September 2021. Five retrospective studies were selected. Results: A total of 3571 studies were included in the initial search. Applying the screening criteria, 299 articles were considered eligible for full-text reading, of which, after applying the exclusion criteria, 4 studies were selected for the final analysis and included in the systematic review. No studies were included for a quantitative analysis. We divided the results according to the location of the recurrence: locoregional recurrence, abdominal recurrence and extra abdominal recurrence. Conclusion: the treatment of choice should be assessed according to the relapse location and to the presence of single or multiple lesions. A crucial role in the decision-making algorithm is also the type of adjuvant treatment received at the time of the first diagnosis.

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Semiquantitative evaluation of lymph-vascular space invasion in patients affected by endometrial cancer: Prognostic and clinical implications

Cited by 33 publications

References 24 publications

Anatomical distribution of sentinel lymph nodes in patients with endometrial cancer: a multicenter study

Anatomical distribution of sentinel lymph nodes in patients with endometrial cancer: a multicenter study

Developing and validating ultrasound‐based radiomics models for predicting high‐risk endometrial cancer

Recurrent Endometrial Cancer: Which Is the Best Treatment? Systematic Review of the Literature

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