Sentinel lymph node mapping with pathologic ultrastaging: A valuable tool for assessing nodal metastasis in low-grade endometrial cancer with superficial myoinvasion Journal Article
| Authors: | Kim, C. H.; Khoury-Collado, F.; Barber, E. L.; Soslow, R. A.; Makker, V.; Leitao, M. M. Jr; Sonoda, Y.; Alektiar, K. M.; Barakat, R. R.; Abu-Rustum, N. R. |
| Article Title: | Sentinel lymph node mapping with pathologic ultrastaging: A valuable tool for assessing nodal metastasis in low-grade endometrial cancer with superficial myoinvasion |
| Abstract: | Objective To report the incidence of nodal metastases in patients presenting with presumed low-grade endometrioid adenocarcinomas using a sentinel lymph node (SLN) mapping protocol including pathologic ultrastaging. Methods All patients from 9/2005 to 12/2011 who underwent endometrial cancer staging surgery with attempted SLN mapping for preoperative grade 1 (G1) or grade 2 (G2) tumors with < 50% invasion on final pathology, were included. All lymph nodes were examined with hematoxylin and eosin (H&E). Negative SLNs were further examined using an ultrastaging protocol to detect micrometastases and isolated tumor cells. Results Of 425 patients, lymph node metastasis was found in 25 patients (5.9%) on final pathology-13 cases on routine H&E, 12 cases after ultrastaging. Patients whose tumors had a DMI < 50% were more likely to have positive SLNs on routine H&E (p < 0.005) or after ultrastaging (p = 0.01) compared to those without myoinvasion. Conclusions Applying a standardized SLN mapping algorithm with ultrastaging allows for the detection of nodal disease in a presumably low-risk group of patients who in some practices may not undergo any nodal evaluation. Ultrastaging of SLNs can likely be eliminated in endometrioid adenocarcinoma with no myoinvasion. The long-term clinical significance of ultrastage-detected nodal disease requires further investigation as recurrences were noted in some of these cases. © 2013 Elsevier Inc. |
| Keywords: | adult; aged; cancer surgery; major clinical study; cancer adjuvant therapy; cancer patient; preoperative care; cancer staging; lymph node metastasis; antineoplastic agent; endometrioid carcinoma; sentinel lymph node mapping; cancer grading; endometrium cancer; sentinel lymph node; clinical protocol; cell isolation; micrometastasis; eosin; hematoxylin; diagnostic test; isolated tumor cells; tumor invasion; lymph vessel metastasis; ultrastaging; human; female; priority journal; article; endometrial cancer staging; low-grade endometrioid carcinoma |
| Journal Title: | Gynecologic Oncology |
| Volume: | 131 |
| Issue: | 3 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2013-12-01 |
| Start Page: | 714 |
| End Page: | 719 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2013.09.027 |
| PROVIDER: | scopus |
| PMCID: | PMC3881432 |
| PUBMED: | 24099838 |
| DOI/URL: | |
| Notes: | Export Date: 2 January 2014 -- CODEN: GYNOA -- Source: Scopus |
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