Sentinel lymph node biopsy alone compared to systematic lymphadenectomy in patients with uterine carcinosarcoma Journal Article


Authors: Zammarrelli, W. A. 3rd; Greenman, M.; Rios-Doria, E.; Miller, K.; Broach, V.; Mueller, J. J.; Aviki, E.; Alektiar, K. M.; Soslow, R. A.; Ellenson, L. H.; Makker, V.; Abu-Rustum, N. R.; Leitao, M. M. Jr.
Article Title: Sentinel lymph node biopsy alone compared to systematic lymphadenectomy in patients with uterine carcinosarcoma
Abstract: Objective: To assess survival among patients diagnosed with uterine carcinosarcoma (CS) who underwent sentinel lymph node (SLN) biopsy alone vs. systematic lymph node dissection (LND). Methods: We identified newly diagnosed CS patients who underwent primary surgical management from January 1996–December 2019. The SLN cohort underwent SLN biopsy alone with bilateral SLNs identified. The systematic LND cohort did not undergo SLN biopsy. Results: Ninety-nine patients underwent SLN biopsy, and 100 patients underwent systematic LND. There was no difference by age, stage, body mass index, myoinvasion (<50%, ≥50%), lymphovascular space invasion, or positive washings. Eighty-five SLN (85.9%) and 15 LND (15%) underwent minimally invasive surgery (P < 0.001). The median total node count was four (range, 1–13) for SLN and 19 (range, 2–50) for LND (P < 0.001). Nodal metastasis occurred in 23 (23.2%) SLN and in 22 (22%) LND (P = 0.4). Postoperative therapy was administered to 85 (85.9%) SLN and 71 (71%) LND (P = 0.02). Median follow-up was 33 months (range, 1–205) for SLN and 55.3 months (range, 1–269) for LND (P = 0.001). The three-year progression-free survival (PFS) was 62.9% (SE 5.2%) for SLN and 52.3% (SE 5.3%) for LND (P = 0.13). The three-year overall survival (OS) was 72.1% (SE 5.1%) for SLN and 71.6% (SE 4.6%) for LND (P = 0.68). An isolated nodal recurrence occurred in two (2%) SLN and four (4%) LND (P = 0.26). Conclusions: There is no difference in PFS or OS among CS patients who undergo SLN biopsy vs. systematic LND. SLN biopsy detects nodal metastasis without compromising oncologic outcomes. © 2022 Elsevier Inc.
Keywords: lymph node dissection; lymph node excision; sentinel lymph node biopsy; transforming growth factor beta; oncology; medical oncology; carcinosarcoma; progression-free survival; uterine carcinosarcoma; systematic lymphadenectomy; humans; human
Journal Title: Gynecologic Oncology
Volume: 165
Issue: 2
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2022-05-01
Start Page: 287
End Page: 292
Language: English
DOI: 10.1016/j.ygyno.2022.02.012
PUBMED: 35232588
PROVIDER: scopus
PMCID: PMC9064992
DOI/URL:
Notes: Article -- Export Date: 1 June 2022 -- Source: Scopus
Altmetric
Citation Impact
MSK Authors
  1. Vicky Makker
    156 Makker
  2. Kaled M Alektiar
    291 Alektiar
  3. Mario Leitao
    445 Leitao
  4. Robert Soslow
    759 Soslow
  5. Jennifer Jean Mueller
    101 Mueller
  6. Vance Andrew Broach
    54 Broach
  7. Emeline Mariam Aviki
    44 Aviki
  8. Kathryn Miller
    10 Miller