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2022-RA-963-ESGO The impact of low-volume metastasis on disease-free survival of women with apparent early-stage endometrial cancerunderwent sentinel node biopsy: a retrospective study
  1. Alessandro A Buda1,
  2. Cristiana Paniga2,
  3. Salih Taskin3,
  4. Michael Mueller4,
  5. Ignacio Zapardiel5,
  6. Francesco Fanfani6,
  7. Andrea Puppo7,
  8. Andrea Papadia8,
  9. Elena de Ponti9,
  10. Hasan Turan10,
  11. Stefania Perotto1,
  12. Mete Gungor11,
  13. Firat Ortac3,
  14. Sara Imboden4,
  15. Fabio Ghezzi12,
  16. Giovanni Scambia6,
  17. Cagatay Taskiran13 and
  18. Robert Fruscio2
  1. 1Gynecology Oncology Unit, Ospedale Michele e Pietro Ferrero, Verduno, Italy
  2. 2Obstetrics and Gynecology, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy
  3. 3Obstetrics and Gynecology, Ankara University School of Medicine, Ankara, Italy
  4. 4Obstetrics and Gynecology, Inselspital, University Hospital of Bern and University of Bern, Bern, Switzerland
  5. 5Gynecologic Oncology Unit., La Paz University Hospital, Madrid, Spain
  6. 6Obstetrics and Gynecology, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, Roma, Italy
  7. 7Obstetrics and Gynecology, Ospedale Santa Croce e Carle, Cuneo, Italy
  8. 8Department of Gynecology and Obstetrics, Ente Ospedaliero Cantonale, University of the Italian Switzerland, Lugano, Switzerland
  9. 9Department of Physical Medicine, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy
  10. 10Department of Obstetrics and Gynecology, University of Health Sciences, İstanbul Training and Research Hospital, İstanbul, İstanbul, Turkey
  11. 11Department of Obstetrics and Gynecology, Acibadem University School of Medicine, İstanbul, Istanbul, Turkey
  12. 12Department of Obstetrics and Gynecology, ‘Filippo Del Ponte’ Hospital, University of Insubria, Varese, Italy
  13. 13Department of Obstetrics and Gynecology, Koc University School of Medicine, Istanbul, Turkey


Introduction/Background We assessed the impact of low-volume metastasis (LVM) on disease-free survival (DFS) of women with apparent early-stage endometrial cancer (EC) that underwent sentinel lymph node (SLN) mapping.

Methodology Patients with preoperative diagnosis of EC were retrospectively collected from eight referring institutions.

Abstract 2022-RA-963-ESGO Figure 1
Abstract 2022-RA-963-ESGO Figure 2
Abstract 2022-RA-963-ESGO Table 1

Univariate and multivariate analysis of DFS

Results 1428 patients were included in this analysis. One hundred and eighty-six patients (13%) had lymph node involvement. Forty-eight percent of positive sentinel lymph nodes had macrometastasis (MAC), 31.3% micrometastasis (MM), and 20.5% isolated tumor cells (ITC). Fifty-seven percent of patients with positive lymph nodes didn’t receive adjuvant therapy. At a median follow-up of 23.7 months, 114 women recurred (8%). Recurrence rate was 28%, 12% and 19% in women with MAC, MM, and ITC, respectively. Patients with MAC in the SLN’s had a worse prognosis in terms of disease-free survival (DFS) compared to patients with negative nodes or with LVM (P< .0001). The type of nodal metastasis did not impact on DFS of patients (HR1.58; p= 0.094). The multivariate analysis showed a difference in DFS when the negative subgroup of women was added to the model (HR 1.26; p= 0.014).

Conclusion In our retrospective study we found that women with MAC have a worse disease DFS compared to women with negative nodes, while the patients with LVM might be considered at intermediate risk. The type of nodal metastasis in the SLN nodes seems to not significantly impact on the risk of recurrence. In the era of molecular profiling, ongoing studies will better clarify the value of SLN biopsy and the of performing a pelvic and/or aortic lymphadenectomy in early-stage EC.

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