Impact of incorporating an algorithm that utilizes sentinel lymph node mapping during minimally invasive procedures on the detection of stage IIIC endometrial cancer Journal Article

  

Authors:	Leitao, M. M.; Khoury-Collado, F.; Gardner, G.; Sonoda, Y.; Brown, C. L.; Alektiar, K. M.; Hensley, M. L.; Soslow, R. A.; Barakat, R. R.; Abu-Rustum, N. R.
Article Title:	Impact of incorporating an algorithm that utilizes sentinel lymph node mapping during minimally invasive procedures on the detection of stage IIIC endometrial cancer
Abstract:	Objective To determine whether the frequency of cases diagnosed with stage IIIC endometrial cancer is affected by the incorporation of a modified surgical lymph node assessment. Methods Since 2008, we have increasingly utilized a modified nodal assessment using an algorithm that incorporates SLN mapping. For this analysis, we identified all cases of newly diagnosed endometrial cancers undergoing a minimally invasive staging procedure not requiring conversion to laparotomy from 1/1/08 to 12/31/10. Procedures were categorized as standard, modified, and hysterectomy only. Differences were based on time period: 2008 (Y1), 2009 (Y2), and 2010 (Y3). Appropriate statistical tests were used. Results We identified a total of 507 cases. The distribution of cases was 143 (Y1), 190 (Y2), and 174 (Y3). Tumor grade (P = 0.05) and high-risk histologies (P = 0.8) did not differ during the 3 time periods. A standard staging procedure was performed in the following cases: Y1 (93/143; 65%), Y2 (66/166; 35%), and Y3 (40/164; 23%) (P < 0.001). Median operative times were as follows: Y1 (218 min), Y2 (198 min), and Y3 (176.5 min) (P < 0.001). The median numbers of total lymph nodes removed among cases with at least 1 node retrieved were: Y1 (20); Y2 (10); Y3 (7) (P < 0.001). Cases diagnosed as stage IIIC were as follows: Y1 (10/143; 7%), Y2 (15/166; 7.9%), and Y3 (13/164; 7.5%) (P = 1.0). Conclusions The incorporation of a modified staging approach utilizing the SLN mapping algorithm reduces the need for standard lymphadenectomy and does not appear to adversely affect the rate of stage IIIC detection. © 2013 Elsevier Inc.
Keywords:	adult; aged; major clinical study; cancer staging; outcome assessment; endometrial cancer; cancer diagnosis; hysterectomy; lymph node dissection; cancer grading; endometrium cancer; laparotomy; prospective study; sentinel lymph node; clinical assessment; histology; feasibility study; algorithm; operation duration; minimally invasive procedure; peroperative complication; sln mapping
Journal Title:	Gynecologic Oncology
Volume:	129
Issue:	1
ISSN:	0090-8258
Publisher:	Elsevier Inc.
Date Published:	2013-04-01
Start Page:	38
End Page:	41
Language:	English
PROVIDER:	scopus
PUBMED:	23321065
DOI:	10.1016/j.ygyno.2013.01.002
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84875460214&partnerID=40&md5=a87e8c91fcbce7846ee40f455589e2ec
Notes:	"Export Date: 1 May 2013" -- "Source: Scopus"

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