RT Journal Article
SR Electronic
T1 Anatomical distribution of sentinel lymph nodes in patients with endometrial cancer: a multicenter study
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP ijgc-2021-003253
DO 10.1136/ijgc-2021-003253
A1 Restaino, Stefano
A1 Buda, Alessandro
A1 Puppo, Andrea
A1 Capozzi, Vito Andrea
A1 Sozzi, Giulio
A1 Casarin, Jvan
A1 Gallitelli, Vitalba
A1 Murgia, Ferdinando
A1 Vizzielli, Giuseppe
A1 Baroni, Alessandro
A1 Corrado, Giacomo
A1 Pasciuto, Tina
A1 Ferrari, Debora
A1 Novelli, Antonia
A1 Berretta, Roberto
A1 Legge, Francesco
A1 Vizza, Enrico
A1 Chiantera, Vito
A1 Ghezzi, Fabio
A1 Landoni, Fabio
A1 Scambia, Giovanni
A1 Fanfani, Francesco
YR 2022
UL http://ijgc.bmj.com/content/early/2022/02/01/ijgc-2021-003253.abstract
AB Objective Sentinel lymph node (SLN) mapping represents the standard approach in uterine confined endometrial cancer patients. The aim of this study was to evaluate the anatomical distribution of SLNs and the most frequent locations of nodal metastasis.Methods This was an observational retrospective multicenter study involving eight high volume gynecologic cancer centers in Italy. We reviewed 1576 patients with a histologically confirmed diagnosis of endometrial cancer from September 2015 to June 2020. All patients underwent total hysterectomy with salpingo-ophorectomy and SLN mapping.Results A total of 3105 SLNs were mapped and removed, 2809 (90.5%) of these were bilateral and 296 (9.5%) unilateral. The overall detection rate was 93.4% (77.9% bilateral and 15.5% unilateral). The majority of SLNs (80%) and positive SLNs (77.8%) were found at the external iliac and obturator level in both endometrioid and non-endometrioid endometrial cancer. Negative SLNs were more frequent in patients with endometrioid compared with non-endometrioid cancer (91.9% vs 86.1%, p<0.0001). Older patients, a higher body mass index, and non-endometrioid histology were more likely to have 'no mapping' (p<0.0001). Univariate and multivariate analysis showed that higher body mass index and age at surgery were independent predictive factors of empty node packet and fat tissue (p=0.029 and p<0.01, respectively).Conclusion The most frequent sites of SLNs and metastases were located in the pelvic area below the iliac vessel bifurcation. Our findings showed that older age, a higher body mass index, and non-endometrioid histology had a negative impact on mapping.Data are available upon reasonable request.