Sentinel lymph node mapping alone compared to more extensive lymphadenectomy in patients with uterine serous carcinoma.

Abstract

OBJECTIVES:

The objective of our study was to assess survival among patients with uterine serous carcinoma (USC) undergoing sentinel lymph node (SLN) mapping alone versus patients undergoing systematic lymphadenectomy (LND).

METHODS:

We retrospectively reviewed patients undergoing primary surgical treatment for newly diagnosed USC at our institution from 1/1/1996-12/31/2017. Patients were assigned to either SLN mapping alone (SLN cohort) or systematic LND without SLN mapping (LND cohort). Progression-free (PFS) and overall survival (OS) were estimated using Kaplan-Meier method, compared using Logrank test.

RESULTS:

245 patients were available for analysis: 79 (32.2%) underwent SLN, 166 (67.7%) LND. 132 (79.5%) in the LND cohort had paraaortic LND (PALND) versus none in the SLN cohort. Median age: 66 and 68 years in the SLN and LND cohorts, respectively (p>0.05). Proportion of stage I/II disease: 67.1% (n = 53) and 64.5% (n = 107) in the SLN and LND cohorts, respectively (p>0.05). Median follow-up: 23 (range, 1-96) and 66 months (range, 4-265) in the SLN and LND cohorts, respectively (p < 0.001). Two-year OS in stage I/II disease (n = 160, 60.1%): 96.6% (SE ± 3.4) and 89.6% (SE ± 2.2) in the SLN and LND cohorts, respectively (p = 0.8). Two-year OS in stage III disease (n = 77): 73.6% (SE ± 10.2) and 77.3% (SE ± 5.8) in the SLN and LND cohorts, respectively (p = 0.8).

CONCLUSIONS:

SLN mapping alone and systematic LND yielded similar survival outcomes in stage I-III USC. In our practice, the SLN algorithm has replaced systematic LND as the primary staging modality in this setting.

• Authors: Derman Basaran, Shaina Bruce, Emeline M Aviki, Jennifer J Mueller, Vance A Broach, Karen Cadoo, Robert A Soslow, Kaled M Alektiar, Nadeem R Abu-Rustum, Mario M Leitao Jr
• Journal: Gynecologic oncology (Gynecol Oncol) Vol. 156 Issue 1 Pg. 70-76 (01 2020) ISSN: 1095-6859 [Electronic] United States
• PMID: 31739992 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2019 Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Cystadenocarcinoma, Serous (mortality, pathology, surgery)
• Endometrial Neoplasms (mortality, pathology, surgery)
• Female
• Humans
• Lymph Nodes (pathology, surgery)
• Middle Aged
• Retrospective Studies
• Sentinel Lymph Node (pathology)
• Sentinel Lymph Node Biopsy (methods)
• Survival Analysis