Sentinel Lymph Node Mapping in Presumed Low- and Intermediate-Risk Endometrial Cancer Management (SLIM): A Multicenter, Prospective Cohort Study in The Netherlands

The aim was to investigate the incidence of sentinel lymph node (SLN) metastases and the contribution of SLN mapping in presumed low- and intermediate-risk endometrial cancer (EC). A multicenter, prospective cohort study in presumed low- and intermediate-risk EC patients was performed. Patients underwent SLN mapping using cervical injections of indocyanine green and a minimally invasive hysterectomy with bilateral salpingo-oophorectomy. The primary outcome was the incidence of SLN metastases, leading to adjusted adjuvant treatment. Secondary outcomes were the SLN detection rate and the occurre... Mehr ...

Verfasser: Lara C. Burg
Roy F. P. M. Kruitwagen
Annemarie de Jong
Johan Bulten
Tijmen J. J. Bonestroo
Arjan A. Kraayenbrink
Dorry Boll
Sandrina Lambrechts
Huberdina P. M. Smedts
Annechien Bouman
Mirjam J. A. Engelen
Jenneke C. Kasius
Ruud L. M. Bekkers
Petra L. M. Zusterzeel
Dokumenttyp: Artikel
Erscheinungsdatum: 2022
Reihe/Periodikum: Cancers, Vol 15, Iss 1, p 271 (2022)
Verlag/Hrsg.: MDPI AG
Schlagwörter: endometrial cancer / low-risk / intermediate-risk / sentinel lymph node mapping / indocyanine green / Neoplasms. Tumors. Oncology. Including cancer and carcinogens / RC254-282
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29169874
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://doi.org/10.3390/cancers15010271

The aim was to investigate the incidence of sentinel lymph node (SLN) metastases and the contribution of SLN mapping in presumed low- and intermediate-risk endometrial cancer (EC). A multicenter, prospective cohort study in presumed low- and intermediate-risk EC patients was performed. Patients underwent SLN mapping using cervical injections of indocyanine green and a minimally invasive hysterectomy with bilateral salpingo-oophorectomy. The primary outcome was the incidence of SLN metastases, leading to adjusted adjuvant treatment. Secondary outcomes were the SLN detection rate and the occurrence of complications. Descriptive statistics and univariate general linear model analyses were used. A total of 152 patients were enrolled, with overall and bilateral SLN detection rates of 91% and 61%, respectively. At final histology, 78.9% of patients ( n = 120) had truly low- and intermediate-risk EC. Macro- and micro-metastases were present in 11.2% ( n = 17/152), and three patients had isolated tumor cells (2.0%). Nine patients (5.9%) had addition of adjuvant radiotherapy based on SLN metastases only. In 2.0% of patients with high-risk disease, adjuvant therapy was more limited due to negative SLNs. This study emphasizes the importance of SLN mapping in presumed early-stage, grade 1 and 2 EC, leading to individualized adjuvant management, resulting in less undertreatment and overtreatment.