Multicenter study comparing oncologic outcomes between two nodal assessment methods in patients with deeply invasive endometrioid endometrial carcinoma: A sentinel lymph node algorithm versus a comprehensive pelvic and paraaortic lymphadenectomy Journal Article


Authors: Schlappe, B. A.; Weaver, A. L.; Ducie, J. A.; Eriksson, A. G. Z.; Dowdy, S. C.; Cliby, W. A.; Glaser, G. E.; Soslow, R. A.; Alektiar, K. M.; Makker, V.; Abu-Rustum, N. R.; Mariani, A.; Leitao, M. M. Jr
Article Title: Multicenter study comparing oncologic outcomes between two nodal assessment methods in patients with deeply invasive endometrioid endometrial carcinoma: A sentinel lymph node algorithm versus a comprehensive pelvic and paraaortic lymphadenectomy
Abstract: Objectives: To compare oncologic outcomes in the staging of deeply invasive endometrioid endometrial carcinoma (EEC) using a sentinel lymph node algorithm (SLN) versus pelvic and paraaortic lymphadenectomy to the renal veins (LND); to compare outcomes in node-negative cases. Methods: At two institutions, patients with deeply invasive (≥50% myometrial invasion) EEC were identified. One institution used LND (2004–2008), the other SLN (2005–2013). FIGO stage IV cases were excluded. Clinical characteristics and follow-up data were recorded. Results: 176 patients were identified (LND, 94; SLN, 82). SLN patients were younger (p = 0.003) and had more LVSI (p < 0.001). 9.8% in the SLN and 29.8% in the LND cohorts, respectively, received no adjuvant therapy (p < 0.001). There was no association between type of assessment and recurrence; adjusted hazard ratio (aHR; LND vs. SLN) 0.87 (95%CI 0.40, 1.89) PFS. After controlling for age and adjuvant therapy, there was no association between assessment method and OS (aHR 2.54; 95%CI 0.81, 7.91). The node-negative cohort demonstrated no association between survival and assessment method: aHR 0.69 (95%CI 0.23, 2.03) PFS, 0.81 (95%CI 0.16, 4.22) OS. In the node-negative cohort, neither adjuvant EBRT+/-IVRT (HR 1.63; 95%CI 0.18, 14.97) nor adjuvant chemotherapy+/-EBRT+/-IVRT (HR 0.49; 95%CI 0.11, 2.22) were associated with OS, compared to no adjuvant therapy or IVRT-only. Conclusion: Use of an SLN algorithm in deeply invasive EEC does not impair oncologic outcomes. Survival is excellent in node-negative cases, irrespective of assessment method. Adjuvant chemotherapy in node-negative patients does not appear to impact outcome. © 2018 Elsevier Inc.
Keywords: endometrial cancer; high-risk; sentinel lymph node algorithm; deep invasion
Journal Title: Gynecologic Oncology
Volume: 151
Issue: 2
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2018-11-01
Start Page: 235
End Page: 242
Language: English
DOI: 10.1016/j.ygyno.2018.08.022
PUBMED: 30177461
PROVIDER: scopus
PMCID: PMC6214768
DOI/URL:
Notes: Article -- Export Date: 3 December 2018 -- Source: Scopus
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MSK Authors
  1. Vicky Makker
    90 Makker
  2. Kaled M Alektiar
    262 Alektiar
  3. Mario Leitao
    329 Leitao
  4. Robert Soslow
    670 Soslow
  5. Jennifer A Ducie
    15 Ducie