The impact of the type of nodal assessment on prognosis in patients with high-intermediate and high-risk ESMO/ESGO/ESTRO group endometrial cancer. A multicenter Italian study

Alessandro Buda, Stefano Restaino, Giampaolo Di Martino, Elena De Ponti, Giorgia Monterossi, Giorgia Dinoi, Sonia Magni, Lorena Quagliozzi, Federica Dell'Orto, Francesca Ciccarone, Maria Lamanna, Giovanni Scambia, Fabio Landoni, Francesco Fanfani

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: The majority of endometrial cancers (EC) are discovered while the disease is confined to the uterine body. The presence of lymph nodes metastases impairs the prognosis. In this study, we evaluated the possible impact on survival of sentinel lymph node (SLN) mapping algorithm and selective lymphadenectomy (LD) in early stage EC, according to the ESMO-ESGO-ESTRO risk subgroup classification.

METHODS: We retrospectively analyzed the database from two collaborative institutions including women with high-intermediate (HI) and high-risk (HR) ESMO/ESGO/ESTRO groups that underwent surgical staging with either SLN mapping, or selective LD.

RESULTS: Two-hundred and sixty-six women were overall identified, 121 in HI and 145 in HR group, respectively. LD was performed in 139 patients (52.5%), whereas SLN mapping algorithm in 61 patients (23%). Sixty-six patients in Rome center were not staged (24.8%). Aortic dissection was performed in 29 women (10.9%). The 3-year comparison did not show a significant difference between strategy adopted for nodal staging (SLN mapping, LD, and SLN + LD) on both disease-free survival [HR: 0.82; 95% CI 0.53-1.28; p = 0.390], and overall survival [HR: 0.78; 95% CI 0.47-1.31; p = 0.355].

CONCLUSIONS: In this study focused on women in the HI and HR groups we did not find difference in the 3-years DFS and OS when comparing the SLN strategy with selective lymphadenectomy, or the SLN algorithm. The SLN strategy did not seem to not compromise the prognosis of high risk patients.

Original languageEnglish
Pages (from-to)1562-1567
Number of pages6
JournalEuropean Journal of Surgical Oncology
Volume44
Issue number10
DOIs
Publication statusPublished - Oct 2018

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Endometrial Neoplasms
Multicenter Studies
Lymph Node Excision
Sentinel Lymph Node
Disease-Free Survival
Dissection
Lymph Nodes
Databases
Neoplasm Metastasis
Survival

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Aorta
  • Carcinoma/secondary
  • Disease-Free Survival
  • Endometrial Neoplasms/pathology
  • Female
  • Humans
  • Italy
  • Lymph Node Excision
  • Lymph Nodes/pathology
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Sentinel Lymph Node Biopsy
  • Survival Rate

Cite this

The impact of the type of nodal assessment on prognosis in patients with high-intermediate and high-risk ESMO/ESGO/ESTRO group endometrial cancer. A multicenter Italian study. / Buda, Alessandro; Restaino, Stefano; Di Martino, Giampaolo; De Ponti, Elena; Monterossi, Giorgia; Dinoi, Giorgia; Magni, Sonia; Quagliozzi, Lorena; Dell'Orto, Federica; Ciccarone, Francesca; Lamanna, Maria; Scambia, Giovanni; Landoni, Fabio; Fanfani, Francesco.

In: European Journal of Surgical Oncology, Vol. 44, No. 10, 10.2018, p. 1562-1567.

Research output: Contribution to journalArticle

Buda, Alessandro ; Restaino, Stefano ; Di Martino, Giampaolo ; De Ponti, Elena ; Monterossi, Giorgia ; Dinoi, Giorgia ; Magni, Sonia ; Quagliozzi, Lorena ; Dell'Orto, Federica ; Ciccarone, Francesca ; Lamanna, Maria ; Scambia, Giovanni ; Landoni, Fabio ; Fanfani, Francesco. / The impact of the type of nodal assessment on prognosis in patients with high-intermediate and high-risk ESMO/ESGO/ESTRO group endometrial cancer. A multicenter Italian study. In: European Journal of Surgical Oncology. 2018 ; Vol. 44, No. 10. pp. 1562-1567.
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abstract = "OBJECTIVES: The majority of endometrial cancers (EC) are discovered while the disease is confined to the uterine body. The presence of lymph nodes metastases impairs the prognosis. In this study, we evaluated the possible impact on survival of sentinel lymph node (SLN) mapping algorithm and selective lymphadenectomy (LD) in early stage EC, according to the ESMO-ESGO-ESTRO risk subgroup classification.METHODS: We retrospectively analyzed the database from two collaborative institutions including women with high-intermediate (HI) and high-risk (HR) ESMO/ESGO/ESTRO groups that underwent surgical staging with either SLN mapping, or selective LD.RESULTS: Two-hundred and sixty-six women were overall identified, 121 in HI and 145 in HR group, respectively. LD was performed in 139 patients (52.5{\%}), whereas SLN mapping algorithm in 61 patients (23{\%}). Sixty-six patients in Rome center were not staged (24.8{\%}). Aortic dissection was performed in 29 women (10.9{\%}). The 3-year comparison did not show a significant difference between strategy adopted for nodal staging (SLN mapping, LD, and SLN + LD) on both disease-free survival [HR: 0.82; 95{\%} CI 0.53-1.28; p = 0.390], and overall survival [HR: 0.78; 95{\%} CI 0.47-1.31; p = 0.355].CONCLUSIONS: In this study focused on women in the HI and HR groups we did not find difference in the 3-years DFS and OS when comparing the SLN strategy with selective lymphadenectomy, or the SLN algorithm. The SLN strategy did not seem to not compromise the prognosis of high risk patients.",
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author = "Alessandro Buda and Stefano Restaino and {Di Martino}, Giampaolo and {De Ponti}, Elena and Giorgia Monterossi and Giorgia Dinoi and Sonia Magni and Lorena Quagliozzi and Federica Dell'Orto and Francesca Ciccarone and Maria Lamanna and Giovanni Scambia and Fabio Landoni and Francesco Fanfani",
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TY - JOUR

T1 - The impact of the type of nodal assessment on prognosis in patients with high-intermediate and high-risk ESMO/ESGO/ESTRO group endometrial cancer. A multicenter Italian study

AU - Buda, Alessandro

AU - Restaino, Stefano

AU - Di Martino, Giampaolo

AU - De Ponti, Elena

AU - Monterossi, Giorgia

AU - Dinoi, Giorgia

AU - Magni, Sonia

AU - Quagliozzi, Lorena

AU - Dell'Orto, Federica

AU - Ciccarone, Francesca

AU - Lamanna, Maria

AU - Scambia, Giovanni

AU - Landoni, Fabio

AU - Fanfani, Francesco

N1 - Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

PY - 2018/10

Y1 - 2018/10

N2 - OBJECTIVES: The majority of endometrial cancers (EC) are discovered while the disease is confined to the uterine body. The presence of lymph nodes metastases impairs the prognosis. In this study, we evaluated the possible impact on survival of sentinel lymph node (SLN) mapping algorithm and selective lymphadenectomy (LD) in early stage EC, according to the ESMO-ESGO-ESTRO risk subgroup classification.METHODS: We retrospectively analyzed the database from two collaborative institutions including women with high-intermediate (HI) and high-risk (HR) ESMO/ESGO/ESTRO groups that underwent surgical staging with either SLN mapping, or selective LD.RESULTS: Two-hundred and sixty-six women were overall identified, 121 in HI and 145 in HR group, respectively. LD was performed in 139 patients (52.5%), whereas SLN mapping algorithm in 61 patients (23%). Sixty-six patients in Rome center were not staged (24.8%). Aortic dissection was performed in 29 women (10.9%). The 3-year comparison did not show a significant difference between strategy adopted for nodal staging (SLN mapping, LD, and SLN + LD) on both disease-free survival [HR: 0.82; 95% CI 0.53-1.28; p = 0.390], and overall survival [HR: 0.78; 95% CI 0.47-1.31; p = 0.355].CONCLUSIONS: In this study focused on women in the HI and HR groups we did not find difference in the 3-years DFS and OS when comparing the SLN strategy with selective lymphadenectomy, or the SLN algorithm. The SLN strategy did not seem to not compromise the prognosis of high risk patients.

AB - OBJECTIVES: The majority of endometrial cancers (EC) are discovered while the disease is confined to the uterine body. The presence of lymph nodes metastases impairs the prognosis. In this study, we evaluated the possible impact on survival of sentinel lymph node (SLN) mapping algorithm and selective lymphadenectomy (LD) in early stage EC, according to the ESMO-ESGO-ESTRO risk subgroup classification.METHODS: We retrospectively analyzed the database from two collaborative institutions including women with high-intermediate (HI) and high-risk (HR) ESMO/ESGO/ESTRO groups that underwent surgical staging with either SLN mapping, or selective LD.RESULTS: Two-hundred and sixty-six women were overall identified, 121 in HI and 145 in HR group, respectively. LD was performed in 139 patients (52.5%), whereas SLN mapping algorithm in 61 patients (23%). Sixty-six patients in Rome center were not staged (24.8%). Aortic dissection was performed in 29 women (10.9%). The 3-year comparison did not show a significant difference between strategy adopted for nodal staging (SLN mapping, LD, and SLN + LD) on both disease-free survival [HR: 0.82; 95% CI 0.53-1.28; p = 0.390], and overall survival [HR: 0.78; 95% CI 0.47-1.31; p = 0.355].CONCLUSIONS: In this study focused on women in the HI and HR groups we did not find difference in the 3-years DFS and OS when comparing the SLN strategy with selective lymphadenectomy, or the SLN algorithm. The SLN strategy did not seem to not compromise the prognosis of high risk patients.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Algorithms

KW - Aorta

KW - Carcinoma/secondary

KW - Disease-Free Survival

KW - Endometrial Neoplasms/pathology

KW - Female

KW - Humans

KW - Italy

KW - Lymph Node Excision

KW - Lymph Nodes/pathology

KW - Lymphatic Metastasis

KW - Middle Aged

KW - Neoplasm Staging

KW - Prognosis

KW - Retrospective Studies

KW - Risk Factors

KW - Sentinel Lymph Node Biopsy

KW - Survival Rate

U2 - 10.1016/j.ejso.2018.06.034

DO - 10.1016/j.ejso.2018.06.034

M3 - Article

C2 - 30077521

VL - 44

SP - 1562

EP - 1567

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

SN - 0748-7983

IS - 10

ER -