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Sentinel node mapping, sentinel node mapping plus back-up lymphadenectomy, and lymphadenectomy in Early-sTage cERvical caNcer scheduled for fertilItY-sparing approach: The ETERNITY project.
- Source :
-
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2024 Sep; Vol. 50 (9), pp. 108467. Date of Electronic Publication: 2024 Jun 08. - Publication Year :
- 2024
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Abstract
- Objective: To investigate the safety of sentinel node mapping for patients with early-stage cervical cancer undergoing cervical conization plus nodal evaluation.<br />Methods: The ETERNITY project is a retrospective, multi-institutional study collecting data of patients with early-stage cervical cancer undergoing fertility-sparing treatment. Here, we compared outcomes related to three methods of nodal assessment: sentinel node mapping (SNM), SNM plus backup lymphadenectomy (SNM + LND); pelvic lymphadenectomy (LND).<br />Results: Charts of 123 patients (with stage IA1-IB1 cervical cancer) were evaluated. Median patients' age was 34 (range, 22-44) years. SNM, SNM + LND, and LND were performed in 32 (26 %), 31 (25.2 %), and 60 (48.8 %) patients, respectively. Overall, eight (6.5 %) patients were diagnosed with positive nodes. Two (3.3 %), three (9.7 %), and three (9.4 %) patients were detected in patients who had LND, SNM + LND, and SNM respectively. Considering the 63 patients undergoing SNM (31 SNM + LND and 32 SNM alone), macrometastases, micrometastases, and isolated tumor cells were detected in four (3.2 %), three (2.4 %), and one (0.8 %) patients, respectively. All patients with positive nodes discontinued the fertility sparing treatment. Other two patients (one (1.7 %) in the LND group and one (3.1 %) in the SNM group) required hysterectomy even after negative nodal evaluation. After a median follow-up of 53.6 (range, 1.3, 158.0) months, nine (7.3 %) and two (1.6 %) patients developed cervical and pelvic nodes recurrences, respectively. Disease-free (p = 0.332, log-rank test) and overall survival (p = 0.769, log-rank test) were similar among groups.<br />Conclusions: In this retrospective experience, SNM upholds long-term oncologic effectiveness of LND, reducing morbidity.<br /> (Copyright © 2024. Published by Elsevier Ltd.)
- Subjects :
- Humans
Female
Adult
Retrospective Studies
Lymphatic Metastasis
Sentinel Lymph Node pathology
Conization methods
Young Adult
Carcinoma, Squamous Cell surgery
Carcinoma, Squamous Cell pathology
Uterine Cervical Neoplasms pathology
Uterine Cervical Neoplasms surgery
Lymph Node Excision methods
Fertility Preservation methods
Sentinel Lymph Node Biopsy methods
Neoplasm Staging
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2157
- Volume :
- 50
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 38901291
- Full Text :
- https://doi.org/10.1016/j.ejso.2024.108467