Sentinel lymph node (SLN) isolated tumor cells (ITCs) in otherwise stage I/II endometrioid endometrial cancer: To treat or not to treat? Journal Article

   

Authors:	Backes, F. J.; Felix, A. S.; Plante, M.; Grégoire, J.; Sullivan, S. A.; Rossi, E. C.; Tanner, E. J. 3rd; Stewart, K. I.; Soliman, P. T.; Holloway, R. W.; Abu-Rustum, N. R.; Leitao, M. M. Jr
Article Title:	Sentinel lymph node (SLN) isolated tumor cells (ITCs) in otherwise stage I/II endometrioid endometrial cancer: To treat or not to treat?
Abstract:	Objectives: To assess associations between treatment and recurrence-free survival (RFS) among patients with isolated tumor cells (ITCs) in sentinel lymph nodes (SLN) and otherwise stage I/II endometrioid endometrial cancer (EC). Methods: A multi-institutional retrospective study of patients with SLN ITCs (<200 cells and < 0.2 mm) was performed. Only patients with otherwise stage I/II EC, endometrioid histology, and no evidence of micro-or macrometastases were included. Univariate and multivariable Cox proportional hazard models were used to evaluate associations between treatment, tumor characteristics, and RFS. Results: 175 patients were included. Median follow up time was 31 months. 39% stage IB and 12% stage II disease. 76 (43%) received no adjuvant therapy or vaginal brachytherapy only (NAT/VBT), 21 (12%) had external beam radiation (EBRT), and 78 (45%) received chemotherapy +/− radiation. Patients who received chemotherapy more often had tumors with deep myoinvasion, lymphovascular space invasion (LVSI), and higher grade. Nine (5.1%) patients recurred; 5 distant, 3 retroperitoneal, and 1 vaginal. Extra-vaginal recurrences were similar in patients with or without chemotherapy (5.2% vs 3.8%, p = 0.68). After controlling for stage, LVSI and grade, chemotherapy and EBRT were not associated with RFS (HR = 0.63, 95%CI 0.11–3.52, and HR = 0.90, 95%CI 0.22–3.61, respectively). Type of lymph node dissection and ITC detection method were not associated with RFS. Conclusions: Risk of retroperitoneal and/or distant recurrence is low (4.6%) for patients with stage I/II endometrioid EC and ITCs in SLNs regardless of treatment. Our preliminary data suggests that adjuvant therapy may not be significantly associated with RFS. However, longer follow-up time and a larger sample size are needed before definitive recommendations regarding adjuvant therapy for patients with EC and only ITCs in SLN can be made. © 2021 Elsevier Inc.
Journal Title:	Gynecologic Oncology
Volume:	161
Issue:	2
ISSN:	0090-8258
Publisher:	Elsevier Inc.
Date Published:	2021-05-01
Start Page:	347
End Page:	352
Language:	English
DOI:	10.1016/j.ygyno.2021.02.017
PUBMED:	33678480
PROVIDER:	scopus
PMCID:	PMC9451004
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85101958375&doi=10.1016%2fj.ygyno.2021.02.017&partnerID=40&md5=989c5daad881b3c55630d1646d2d15e8
Notes:	Article -- Export Date: 3 May 2021 -- Source: Scopus

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