Three-Year Recurrence-Free Survival in Patients With a Very Low Risk of Endometrial Cancer Who Did Not Undergo Lymph Node Dissection (Tree Retro)

Kim, Miseon; Choi, Chang-Won; Kim, Kidong; Lim, Myong Cheol; Lee, Maria; Paek, Jiheum; Seoung, Jungyeob; Lee, Seungho; Lee, Taek Sang

doi:10.1097/igc.0000000000001270

Cited by 3 publications

(4 citation statements)

References 24 publications

(15 reference statements)

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“…Unfortunately, they need to be based on pathological results. Kim et al [13] recently proposed a new KGOG standard, and the 3-year RFS and 5-year OS were 98.6% and 98.6%, respectively. However, the clinical imaging diagnosis of myometrial invasion and lymph node size had a certain misdiagnosis rate, especially CT.…”

Section: Discussionmentioning

confidence: 99%

“…We included 36 consecutive patients who had staged surgery for endometrial cancer between 2016 and 2018. Bilateral salpingo-oophorectomy and peritoneal irrigation cytology were at the discretion of the surgeon [13]. All eligible patients met the following very low risk criteria for lymph node metastasis, including:…”

Section: Methodsmentioning

confidence: 99%

“…We obtained the final pathological results, including the stage according to the International Federation of Obstetricians and Gynecologists (FIGO), the type and grade of histology, the presence of malignant cells in peritoneal flushing cytology, the number of recovered lymph nodes, and the involved lymph nodes. The final pathological results indicate that the patients are middle-risk or high-risk, and receive adjuvant treatment based on the postoperative results [13]. Table 1 summarizes the preoperative characteristics of the study population.…”

Section: Methodsmentioning

confidence: 99%

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Is lymph node dissection mandatory among early stage endometrial cancer patients? A retrospective study

Guangmin¹,

Chen²,

Li³

et al. 2020

BMC Women's Health

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Background Whether routine lymph node dissection for early endometrial cancer is beneficial to survival is still controversial. However, surgeons usually perform lymph node dissection on all patients with early endometrial cancer. This study aimed to prove that the risk of lymph node metastasis, as defined by our standard, is very low in such patients and may change the current surgical practice. Methods 36 consecutive patients who had staged surgery for endometrial cancer were collected. All eligible patients meet the following very low risk criteria for lymph node metastasis, including: (1) preoperative diagnosis of endometrial cancer (preoperative pathological diagnosis), (2) tumors confined to the uterine cavity and not beyond the uterine body, (3) PET-MRI lymph node metastasis test is negative. PET-MRI and pathological examination were used to assess the extent and size of the tumor, the degree of muscular invasion, and lymph node metastasis. Results The median age at diagnosis was 52 years (range 35–72 years). The median tumor size on PET-MRI was 2.82 cm (range 0.66–6.37 cm). Six patients underwent robotic surgery, 20 underwent laparoscopic surgery, 8 underwent Laparoscopic-assisted vaginal hysterectomy, and 2 underwent vaginal hysterectomy. 23% (63.9%) patients had high-grade (i.e. 2 and 3) tumors. Among the 36 patients who underwent lymph node sampling, the median number of lymph nodes retrieved was 32 (range 9–57 nodules). No patient (0%) was diagnosed with lymph node metastasis. According to the policy of each institution, 8 patients (22.2%) received adjuvant therapy, and half of them also received chemotherapy (4 patients; 50%). Conclusions None of the patients who met the criteria had a pathological assessment of lymph node metastasis. Omitting lymph node dissection may be reasonable for patients who meet our criteria.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Is lymph node dissection mandatory among early stage endometrial cancer patients? A retrospective study

Guangmin¹,

Chen²,

Li³

et al. 2020

BMC Women's Health

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“…Another low-risk criterion for the omission was proposed based on preoperative tests, but the imaging of myometrial invasion and lymph node involvement had a misdiagnosis rate of up to 20% and did not assess the tumor size on imaging. 26 The classic criteria were also analyzed in several 1 Risk Factor: studies: regarding the depth of myometrial invasion with MRI, 6,26 there were misleading cases, and concerning the histological grade of the tumor, there was a difference between the grade determined in the previous biopsy and the hysterectomy specimen. 27 The discrepancy between the pre-and postsurgery findings generated the search for new preoperative tools that allowed a correct tailored surgery.…”

Section: Discusionmentioning

confidence: 99%

Values of tumor volume on magnetic resonance imaging for a surgical approach to endometrial cancer

López‐González,

Rodríguez‐Jiménez,

Rojas‐Luna

et al. 2023

Cancer Medicine

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ObjectiveTo analyze the relationship between tumor volume in Endometrial Cancer (EC) on Magnetic Resonance Imaging (MRI) and lymph node metastasis to establish which patients benefit from omitting the lymphadenectomy.MethodsA retrospective observational study with 194 patients with EC identified between 2016 and 2021 at the Juan Ramón Jiménez University Hospital, Huelva (Spain) was carried out. Preoperative MRI of 127 patients was assessed. The tumor volume was analyzed on MRI by the ellipsoid formula and another alternative method with a manual ROI in different sections. Risk factors for node metastases were analyzed to understand its relationship and to identify an optimum criterion for the tailored surgery.ResultsUnivariate analysis showed risk factors for lymph node metastases were histological grade (p = 0.001), tumor with a volume greater than >25 cm3 (p < 0.001), lymphovascular space invaded (p = 0.007), and preoperative Ca 125 serum >28 (p < 0.001). Multivariate analysis indicated that tumor volume index >25 cm3 was an independent risk factor for lymph node metastases. The patients without significant proposed risk factors (volume index >25 cm3 [OR = 0.64], Ca 125 > 28 [OR = 0.32], and high histological grade [OR = 2.6]) did not present lymph node metastases, independent of myometrial invasion.ConclusionsLymphadenectomy can be omitted in patients with Endometrioid carcinoma that do not have any of the following risk factors: high‐grade tumor, elevated Ca 125 (>28), and tumor volume on MRI greater than 25 cm3. Tumor volume might predict the state of lymph nodes in EC and it could give information regarding surgical management.

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RETRACTED ARTICLE: The role of lymph node dissection in the surgical treatment of endometrial cancer patients (retrospective analysis)

Movchan

Svintsitskyi

2022

J Cancer Res Clin Oncol

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Three-Year Recurrence-Free Survival in Patients With a Very Low Risk of Endometrial Cancer Who Did Not Undergo Lymph Node Dissection (Tree Retro)

Abstract: Very low-risk patients who did not undergo lymph node dissection had acceptable survival outcomes. Omitting lymph node dissection may be reasonable in patients satisfying the KGOG criteria.

Cited by 3 publications

References 24 publications

Is lymph node dissection mandatory among early stage endometrial cancer patients? A retrospective study

Is lymph node dissection mandatory among early stage endometrial cancer patients? A retrospective study

Values of tumor volume on magnetic resonance imaging for a surgical approach to endometrial cancer

RETRACTED ARTICLE: The role of lymph node dissection in the surgical treatment of endometrial cancer patients (retrospective analysis)

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