Simple perinephric adipose tissue measurement for prediction of failed sentinel lymph node mapping in endometrial cancer.

IF 4.1 2区医学 Q1 OBSTETRICS & GYNECOLOGY

International Journal of Gynecological Cancer Pub Date : 2025-05-23 DOI:10.1016/j.ijgc.2025.101949

Lina Salman, Paulina Cybulska, Ryley Fowler, Manjula Maganti, Ur Metser, Sarah E Ferguson

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引用次数: 0

Abstract

Objective: We aimed to evaluate whether pre-operative average perinephric fat is associated with sentinel lymph node (SLN) mapping, peri-operative complications, and survival in endometrial cancer.

Methods: This was a retrospective cohort study of endometrial cancer patients who underwent surgical staging with SLN mapping between 2015 and 2021. Average perinephric fat was measured on axial sections of pre-operative computed tomography scans. Baseline characteristics and average perinephric fat measurements were compared between patients with successful mapping and those with bilateral failed mapping. We also compared peri-operative complications between patients with high and low average perinephric fat.

Results: Of the 297 participants included, 274 (92%) had at least unilateral successful SLN mapping, while 23 (8%) had bilateral failed SLN mapping. Median body mass index (34.7 vs 29.8 kg/m², p = .01) and average perinephric fat (1.5 vs 1.0 cm, p = .02) were significantly higher among patients with failed mapping. In univariate logistic regression, body mass index (OR 1.07, 95% CI 1.03 to 1.12, p = .001) and average perinephric fat (OR 1.43, 95% CI 1.13 to 1.80, p = .003) were associated with failed mapping. Using receiver operating characteristic curve analysis, a cut-off of 2.2 cm for average perinephric fat was a significant predictor of failed mapping (OR 7.62, 95% CI 2.85 to 20.3, p < .001). There was no significant difference in intra-operative (4% vs 3%) or post-operative complications (19% vs 14%) between those with average perinephric fat ≥ 2.2 cm and <2.2 cm (p > .05).

Conclusions: Increased average perinephric fat is associated with a higher risk of failed SLN mapping in endometrial cancer, without an associated increase in peri-operative complications. Incorporating this simple measurement into clinical practice may add value in identifying and counseling individuals at higher risk for failed mapping.

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简单的肾周脂肪组织测量预测子宫内膜癌前哨淋巴结定位失败。

目的：我们旨在评估术前平均肾周脂肪是否与子宫内膜癌前哨淋巴结（SLN）定位、围手术期并发症和生存率相关。方法：这是一项回顾性队列研究，研究对象是2015年至2021年间接受SLN定位手术分期的子宫内膜癌患者。在术前计算机断层扫描的轴向切片上测量平均肾周脂肪。基线特征和平均肾周脂肪测量比较成功测图和双侧测图失败的患者。我们还比较了高和低平均肾周脂肪患者的围手术期并发症。结果：在纳入的297名参与者中，274名（92%）至少单侧SLN定位成功，而23名（8%）双侧SLN定位失败。测图失败的患者中位体重指数（34.7 vs 29.8 kg/m2, p = 0.01）和平均肾周脂肪（1.5 vs 1.0 cm, p = 0.02）显著高于对照组。在单因素logistic回归中，体重指数（OR 1.07, 95% CI 1.03至1.12,p = 0.001）和平均肾周脂肪（OR 1.43, 95% CI 1.13至1.80,p = 0.003）与映射失败相关。使用受试者工作特征曲线分析，平均肾周脂肪2.2 cm的截止值是失败的重要预测因子（OR 7.62, 95% CI 2.85至20.3,p < .001）。平均肾周脂肪≥2.2 cm者术中（4% vs 3%）或术后并发症（19% vs 14%）与平均肾周脂肪≥0.05者无显著差异。结论：平均肾周脂肪增加与子宫内膜癌SLN定位失败的高风险相关，但未增加围手术期并发症。将这种简单的测量方法结合到临床实践中，可能会增加识别和咨询高危人群的价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Gynecological Cancer 医学-妇产科学

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.