Sentinel SENECA risk factors for unsuccessful bi-lateral sentinel lymph node mapping in endometrial cancer.

IF 4.1 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Félix Boria, Enrique Chacón, R Rajagopalan Iyer, Francesco Fanfani, Francesca Falcone, Petra Bretová, Ana Luzarraga Aznar, Robert Fruscio, Marcin Jedryka, Richard Tóth, Artem Stepanyan, Gurkan Kiran, Cecilia Darin, Agnieszka Rychlik, Ester Miralpeix, Meriem Koual, Roberto Berretta, Natalia Anna Palasz, Duska Beric, Dimitrios Tsolakidis, Soledad Fidalgo, Richard Schwameis, Somashekhar Sp, Ibrahim Yalcin, Radovan Pilka, Cagatay Taskiran, Despoina Myoteri, Estibaliz Iza Rodriguez, Dariusz G Wydra, Silvia Catot, Mathias Fehr, Frederic Goffin, Maria Ercilia Ibarra, Stamatios Petousis, Enrique Moratalla Bartolomé, Mareike Bommert, Alfonso Quesada, Shamistan Aliyev, José Ángel Mínguez, Luis Chiva
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引用次数: 0

Abstract

Objective: Our study aims to assess the risk factors associated with bi-lateral sentinel lymph node (SLN) mapping failure in endometrial cancer.

Methods: The SENECA study was a retrospective multi-center international observational study that reviewed data from 2139 women with clinical stage I-to-II endometrial cancer across 64 centers in 17 countries. Between January 2021 and December 2022, patients underwent surgical treatment with SLN assessment, following the guidelines of the European Society of Gynaecological Oncology. Risk factors associated with the absence of bi-lateral mapping were analyzed using χ2 and t tests. All factors that showed statistical associations were included in a multi-variate regression analysis.

Results: Among the 2139 patients, the bi-lateral lymph node detection rate was 82.7%, whereas the unilateral detection rate was 97.3%. In multi-variate analysis, 5 risk factors remained statistically associated with unsuccessful bi-lateral lymph node mapping: high-grade histology (OR 1.35, 95% CI 1.02 to 1.79, p=.03), myometrial invasion >50% (OR 1.37, 95% CI 1.07 to 1.75, p=.012), low-volume surgeon <20 cases/year (OR 2.11, 95% CI 1.55 to 2.89, p<.01), open surgical approach (OR 1.72, 95% CI 1.06 to 2.78 , p=.03), and non-indocyanine green tracer (OR 4.59, 95% CI 2.64 to 7.99, p<.01). The addition of bi-lateral pelvic lymphadenectomy and/or paraaortic lymphadenectomy to SLN biopsy caused an increased rate of intra-operative complications (2% vs 8.4%, p<.01) and all-grade post-operative complications (4.1% vs 11.2%, p<.01).

Conclusions: Our study identifies 5 risk factors associated with unsuccessful lymph node mapping in endometrial cancer. Efforts should be made to perform this technique with indocyanine green, through minimally invasive surgery, and performed or supervised by an experienced surgeon with ≥20 endometrial cancer cases per year.

子宫内膜癌双侧前哨淋巴结定位不成功的前哨SENECA危险因素。
目的:本研究旨在评估与子宫内膜癌双侧前哨淋巴结(SLN)定位失败相关的危险因素。方法:SENECA研究是一项回顾性多中心国际观察性研究,回顾了来自17个国家64个中心的2139名临床i- ii期子宫内膜癌妇女的数据。在2021年1月至2022年12月期间,根据欧洲妇科肿瘤学会的指导方针,患者接受了SLN评估的手术治疗。采用χ2和t检验分析与双侧图谱缺失相关的危险因素。所有显示统计学关联的因素均纳入多元回归分析。结果2139例患者中,双侧淋巴结检出率为82.7%,单侧淋巴结检出率为97.3%。在多因素分析中,5个危险因素与双侧淋巴结定位不成功仍有统计学相关性:高级别组织学(OR 1.35, 95% CI 1.02 ~ 1.79, p = 0.03),肌层浸润bbb50 % (OR 1.37, 95% CI 1.07 ~ 1.75, p = 0.012),小体积外科医生。结论:我们的研究确定了子宫内膜癌中与淋巴结定位不成功相关的5个危险因素。应通过微创手术,并由每年≥20例子宫内膜癌病例的经验丰富的外科医生执行或监督,努力使用吲哚菁绿来实施这项技术。
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来源期刊
CiteScore
6.60
自引率
10.40%
发文量
280
审稿时长
3-6 weeks
期刊介绍: The International Journal of Gynecological Cancer, the official journal of the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology, is the primary educational and informational publication for topics relevant to detection, prevention, diagnosis, and treatment of gynecologic malignancies. IJGC emphasizes a multidisciplinary approach, and includes original research, reviews, and video articles. The audience consists of gynecologists, medical oncologists, radiation oncologists, radiologists, pathologists, and research scientists with a special interest in gynecological oncology.
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