1. Long-term oncological safety of sentinel lymph node biopsy in early-stage cervical cancer: A post-hoc analysis of SENTICOL I and SENTICOL II cohorts
- Author
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Jean Lévêque, Virginie Fourchotte, Laurent Magaud, Eric Leblanc, Marc Baron, Philippe Morice, Benedetta Guani, Denis Querleu, Patrice Mathevet, Emile Daraï, Vincent Balaya, Henri Marret, Fabrice Lecuru, INSERM, Université de Lille, Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U1192, Centre Hospitalier Universitaire Vaudois [Lausanne] [CHUV], Institut Gustave Roussy [IGR], CHU Strasbourg, Institut Curie [Paris], CHU Tenon [AP-HP], Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen [CLCC Henri Becquerel], Hôpital Bretonneau, Centre Hospitalier Universitaire [Rennes], Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS], Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Institut Gustave Roussy (IGR), Département de chirurgie gynécologique [Gustave Roussy], Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université de Lille-UNICANCER, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Pontchaillou [Rennes], and Hospices Civils de Lyon (HCL)
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Adult ,medicine.medical_specialty ,Multivariate analysis ,SENTICOL ,Sentinel lymph node ,Urology ,Uterine Cervical Neoplasms ,Oncologic outcomes ,Disease-Free Survival ,Cohort Studies ,Young Adult ,Risk Factors ,Post-hoc analysis ,Biopsy ,medicine ,Humans ,Prospective Studies ,Stage (cooking) ,Pelvic lymphadenectomy ,Aged ,Neoplasm Staging ,Proportional Hazards Models ,Aged, 80 and over ,Cervical cancer ,Risk level ,medicine.diagnostic_test ,Sentinel Lymph Node Biopsy ,business.industry ,Obstetrics and Gynecology ,Middle Aged ,medicine.disease ,Oncology ,Female ,Disease-free survival ,France ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience; Objectives: To compare oncologic outcomes of patients with early-stage cervical cancer and negative nodes who underwent sentinel lymph node biopsy alone (SLNB) versus pelvic lymphadenectomy (PL).Methods: An ancillary analysis of two prospective multicentric trials on SLN biopsy for cervical cancer (SENTICOL I and II) was conducted. Only patients with early-stage cervical cancer (IA to IIA FIGO stage), bilateral detection of SLN, negative SLN after ultrastaging and negative non-SLN after final pathologic examination were included. Risk-factors of recurrence and disease-specific mortality were determined by Cox proportional hazard models.Results: Between January 2005 and July 2012, 259 node-negative patients were analyzed: 87 in the SLNB group and 172 in the PL group. The median follow-up was 47 months [4-127]. During the follow-up, 21 patients (8.1%) experienced recurrences, including 4 nodal recurrences (1.9%), and 9 patients (3.5%) died of cervical cancer. Disease-free survival (DFS) and disease-specific survival (DSS) were similar between SLNB and PL groups, 85.1% vs. 80.4%, p = 0.24 and 90.8% vs. 97.2%, p = 0.22 respectively. By Cox multivariate analysis, SLNB compared to PL was not associated with DFS (HR = 1.78, 95%CI = [0.71-4.46], p = 0.22) neither with DSS (HR = 3.02, 95%CI = [0.69-13.18], p = 0.14). Only pathologic risk level according to the Sedlis criteria was an independent predictor of DFS and DSS.Conclusions: Omitting full pelvic lymphadenectomy for patients with bilateral negative SLN does not seem to be associated with an increased risk of recurrence in this series. Survival non-inferiority needs to be confirmed by prospective trials.
- Published
- 2022
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