Survival of patients with serous uterine carcinoma undergoing sentinel lymph node mapping Journal Article

Authors: Schiavone, M. B.; Scelzo, C.; Straight, C.; Zhou, Q.; Alektiar, K. M.; Makker, V.; Soslow, R. A.; Iasonos, A.; Leitao, M. M.; Abu-Rustum, N. R.
Article Title: Survival of patients with serous uterine carcinoma undergoing sentinel lymph node mapping
Abstract: Objective: The aim of this study was to determine progression-free survival (PFS) in patients with serous uterine carcinoma undergoing sentinel lymph node (SLN) mapping compared with patients undergoing standard lymphadenectomy. Methods: We retrospectively reviewed all uterine cancer patients treated at our institution from 2005 to 2015. Patients were separated into two cohorts: those who underwent SLN mapping at the time of staging (SLN) and those who underwent routine lymphadenectomy (the non-SLN group). SLN mapping was performed according to institutional protocol, incorporating a surgical algorithm and pathologic ultrastaging. Results: Overall, 248 patients were identified—153 SLN mappings and 95 routine lymphadenectomies (pelvic and/or paraaortic lymph node dissection). No significant difference in age or body mass index was observed between the groups (p = 0.08 and p = 0.9, respectively). Minimally invasive surgery was utilized in 117/153 (77%) SLN patients and 30/95 (32%) non-SLN patients (p = <0.001). Stage distribution for the SLN and non-SLN cohorts demonstrated 106/153 (69%) and 59/95 (62%) patients with stage I/II disease, respectively, and 47/153 (31%) and 36/95 (38%) patients with stage III/IV disease, respectively (p = 0.3). The median number of nodes removed was 12 (range, 1–50) in the SLN cohort versus 21 (range, 1–75) in the non-SLN cohort (p = <0.001). Adjuvant chemotherapy alone or with radiation therapy was administered in 122/153 (80%) SLN patients and 79/95 (83%) non-SLN patients; radiotherapy alone was administered in 12/153 (8%) SLN patients and 7/95 (7%) non-SLN patients (p = 0.8). At a median follow-up of 40 months, the 2-year PFS rates were 77% (95% confidence interval [CI], 68–83%) in the SLN group and 71% (95% CI, 61–79%) in the non-SLN group (p = 0.3). Conclusions: Incorporation of the SLN mapping algorithm into the staging of uterine serous cancer is feasible and does not appear to compromise prognosis. PFS in patients with uterine serous carcinoma undergoing SLN mapping, followed by adjuvant therapy, was similar to PFS in patients undergoing standard lymphadenectomy and adjuvant therapy. © 2017, Society of Surgical Oncology.
Keywords: adult; cancer survival; controlled study; aged; major clinical study; cancer adjuvant therapy; cancer patient; cancer radiotherapy; comparative study; cancer staging; follow up; endometrium carcinoma; hysterectomy; lymph node dissection; paraaortic lymph node; sentinel lymph node mapping; laparoscopic surgery; laparotomy; sentinel lymph node; progression free survival; computer assisted tomography; retrospective study; body mass; medical record; minimally invasive surgery; human; female; article; radiation oncologist
Journal Title: Annals of Surgical Oncology
Volume: 24
Issue: 7
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2017-07-01
Start Page: 1965
End Page: 1971
Language: English
DOI: 10.1245/s10434-017-5816-4
PROVIDER: scopus
PUBMED: 28258415
PMCID: PMC6092025
Notes: Article -- Export Date: 3 July 2017 -- Source: Scopus
Citation Impact
MSK Authors
  1. Vicky Makker
    202 Makker
  2. Kaled M Alektiar
    317 Alektiar
  3. Mario Leitao
    492 Leitao
  4. Qin Zhou
    209 Zhou
  5. Alexia Elia Iasonos
    303 Iasonos
  6. Robert Soslow
    789 Soslow
  7. Chiara Scelzo
    3 Scelzo