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  • 2022-RA-859-ESGO Long-term survival outcomes in high-risk endometrial cancer patients undergoing sentinel lymph node biopsy vs. lymphadenectomy

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Endometrial cancer
2022-RA-859-ESGO Long-term survival outcomes in high-risk endometrial cancer patients undergoing sentinel lymph node biopsy vs. lymphadenectomy
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  1. Vito Andrea Capozzi1,
  2. Elisa Scarpelli1,
  3. Andrea Rosati2,
  4. Virginia Vargiu3,
  5. Giulio Sozzi4,
  6. Giuseppe Maglietta5,
  7. Giulia Armano1,
  8. Diana Butera1,
  9. Luciano Monfardini1,
  10. Michela Gaiano1,
  11. Gabriella Celora1,
  12. Giuseppe Barresi1,
  13. Alessandra de Finis1,
  14. Isabella Rotondella1,
  15. Vito Chiantera6,
  16. Francesco Cosentino2,
  17. Francesco Fanfani2,
  18. Giovanni Scambia2,
  19. Tullio Ghi1 and
  20. Roberto Berretta1
  1. 1Gynecology and Obstetrics, University of Parma, Parma, Italy
  2. 2Division of Gynecologic Oncology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, Roma, Italy
  3. 3Gemelli Molise SpA, Campobasso, Italy
  4. 4Department of Gynecologic Oncology, University of Palermo, Palermo, Italy
  5. 5Clinical and Epidemiological Research Unit, University of Parma, Parma, Italy
  6. 6Unit of Gynecologic Oncology, ARNAS ‘Civico – Di Cristina – Benfratelli’, Palermo, Italy

Abstract

Introduction/Background High-risk endometrial cancers (HREC) have a poor prognosis, are diagnosed at an advanced stage, and represent 15% of all ECs. In these cases, nodal surgical staging is strongly recommended. Traditionally, pelvic and aortic lymphadenectomy (LMP) is performed with relevant post-operative morbidity. Recently, the introduction of sentinel node biopsy (SLN) also in HREC cases offered a less invasive technique with a high accuracy rate. However, the long-term SLN impact on patients’ survival is not yet known. The study aims to analyze the long-term survival of HREC patients undergoing SLN biopsy versus systematic LMP.

Abstract 2022-RA-859-ESGO Figure 1
Abstract 2022-RA-859-ESGO Figure 1

Methodology A retrospective multicentre study was conducted. All HREC patients undergoing surgical treatment were divided into SLN group (group 1) and LMP group (group 2). ESGO/ESTRO/ESP risk class was used to identify HREC patients. A minimum follow-up of 12 months was required for each case.

Results Of the 177 patients who meet the inclusion criteria, 83 underwent SLN biopsy and 94 cases were staged with systematic LMP. The median follow-up was 36 months (12–46). No significant differences in median age (p=0.439), median BMI (0.268), FIGO stage (p=0.164), and adjuvant therapy (p=0.775) were found in the two groups. Thirty-two recurrences were registered (14 in the SLN and 18 in the LMP group) and 15 cancer-related deaths were reported (8 in the SLN and 7 in the LMP group). One-year OS was 100 vs. 100%, 2-year OS was 94 vs. 95%, and 3-years OS was 92 vs. 93% in groups 1 and 2, respectively (hazard ratio 0.73, Confidence Intervall 95% 0.26–2.00, p=0.54). One-year DFS was 96.4 vs. 97.9%, 2-years DFS was 85.2 vs. 86.7%, and 3-year DFS was 83.4 vs. 83.2 in groups 1 and 2, respectively (hazard ratio 1.01, Confidence Intervall 95% 0.48–2.13, p=0.97).

Conclusion SLN biopsy shows long-term survival outcomes superimposable to systematic LMP in HREC patients.

https://doi.org/10.1136/ijgc-2022-ESGO.251

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