Call for Surgical Nodal Staging in Women with ESMO/ESGO/ESTRO High–Intermediate Risk Endometrial Cancer: A Multicentre Cohort Analysis from the FRANCOGYN Study Group
Background The European Society of Medical Oncology (ESMO)/European Society of Gynaecological Oncology (ESGO)/European Society for Radiotherapy & Oncology (ESTRO) classification for endometrial cancer (EC) now includes a high–intermediate risk (HIR) group of recurrence due to the adverse prognos...
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| Veröffentlicht in: | Annals of surgical oncology 2017-06, Vol.24 (6), p.1660-1666 |
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| creator | Ouldamer, L. Bendifallah, S. Body, G. Canlorbe, G. Touboul, C. Graesslin, O. Raimond, E. Collinet, P. Coutant, C. Lavoué, V. Lévêque, J. Daraï, E. Ballester, M. |
| description | Background
The European Society of Medical Oncology (ESMO)/European Society of Gynaecological Oncology (ESGO)/European Society for Radiotherapy & Oncology (ESTRO) classification for endometrial cancer (EC) now includes a high–intermediate risk (HIR) group of recurrence due to the adverse prognostic role of lymphovascular space involvement (LVSI) and grade 3 for women at intermediate risk. However, optimal surgical staging, and especially the place of lymphadenectomy, remains to be elucidated. We aimed to establish whether systematic nodal staging should be part of surgical staging for women with HIR EC.
Methods
We abstracted from a prospectively maintained multicentre database the data of 181 women with HIR EC based on uterine factors (endometrioid type 1, grade 1–2 tumors with deep (≥50%) myometrial invasion and unequivocally positive LVSI, and those with grade 3 tumors with |
| doi_str_mv | 10.1245/s10434-016-5731-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_01543368v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1899617807</sourcerecordid><originalsourceid>FETCH-LOGICAL-c406t-d581b7470bb106bfaa7093ee52135f0332d95d925f6706c6a72b6fa8a2ee431e3</originalsourceid><addsrcrecordid>eNp1kUFu1DAUhiMEoqVwADbIEhtYhNpx7Djsomg6U2k6I80UIVaWkzgZl8QebAc0O-7AIbgXJ8FRSoWQ2Dxbz9_7_T_9UfQSwXcoScmlQzDFaQwRjUmGUQwfReeIhE5KGXoc7pCyOE8oOYueOXcHIcowJE-js4RBwghh59HPUvQ9aI0F-9F2qhY92Jgm1L0XndIdUBp8NIPU4JvyB7DY32wvF_vlVG53W7BS3eHX9x_X2ks7yEYJL8FOuc9goZsw5a0KUqXQtbTvQQFuxt6rWmpvJSjNwVgPCi36k1MOtNYMwB8kuNoVm3K7_LQJHsbmBJbWjMfn0ZNW9E6-uD8vog9Xi9tyFa-3y-uyWMd1CqmPG8JQlaUZrKqwfNUKkcEcS0kShEkLMU6anDR5QlqaQVpTkSUVbQUTiZQpRhJfRG9n3YPo-dGqQdgTN0LxVbHmUw8ikmJM2VcU2Dcze7Tmyyid54Nytex7oaUZHUeMUJIjynBAX_-D3pnRhtUnKs8pyhjMAoVmqrbGOSvbBwcI8ilxPiceTFA-Jc5hmHl1rzxWIYGHiT8RByCZAReedCftX1__V_U3wnK0yQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1899617807</pqid></control><display><type>article</type><title>Call for Surgical Nodal Staging in Women with ESMO/ESGO/ESTRO High–Intermediate Risk Endometrial Cancer: A Multicentre Cohort Analysis from the FRANCOGYN Study Group</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Ouldamer, L. ; Bendifallah, S. ; Body, G. ; Canlorbe, G. ; Touboul, C. ; Graesslin, O. ; Raimond, E. ; Collinet, P. ; Coutant, C. ; Lavoué, V. ; Lévêque, J. ; Daraï, E. ; Ballester, M.</creator><creatorcontrib>Ouldamer, L. ; Bendifallah, S. ; Body, G. ; Canlorbe, G. ; Touboul, C. ; Graesslin, O. ; Raimond, E. ; Collinet, P. ; Coutant, C. ; Lavoué, V. ; Lévêque, J. ; Daraï, E. ; Ballester, M. ; Groupe de Recherche FRANCOGYN ; For the Groupe de Recherche FRANCOGYN</creatorcontrib><description>Background
The European Society of Medical Oncology (ESMO)/European Society of Gynaecological Oncology (ESGO)/European Society for Radiotherapy & Oncology (ESTRO) classification for endometrial cancer (EC) now includes a high–intermediate risk (HIR) group of recurrence due to the adverse prognostic role of lymphovascular space involvement (LVSI) and grade 3 for women at intermediate risk. However, optimal surgical staging, and especially the place of lymphadenectomy, remains to be elucidated. We aimed to establish whether systematic nodal staging should be part of surgical staging for women with HIR EC.
Methods
We abstracted from a prospectively maintained multicentre database the data of 181 women with HIR EC based on uterine factors (endometrioid type 1, grade 1–2 tumors with deep (≥50%) myometrial invasion and unequivocally positive LVSI, and those with grade 3 tumors with <50% myometrial invasion regardless of LVSI status), who received primary surgical treatment between January 2001 and December 2013. We recorded frequency of lymph node (LN) metastases in those who underwent nodal staging. The secondary outcomes were overall survival and recurrence patterns.
Results
Overall, 145 (80.1%) women underwent nodal staging consisting of at least pelvic lymphadenectomy. Of these, 62 (42.7%) had LN disease (9.7% with micrometastases). The respective 5-year overall survival rates according to LN status were 85.0% (95% confidence interval [CI] 76.5–91.4), 71.8% (95% CI 61.9–80.4) and 36.0% (95% CI 26.6–46.2) for women with negative LN, positive LN, and unstaged (
p
= 0.047). Unstaged women were more likely to experience nodal recurrence than surgically staged/LN negative women (
p
= 0.05).
Conclusions
Systematic nodal staging should be part of surgical staging for women with apparent ESMO/ESGO/ESTRO HIR EC. Sentinel LN biopsy (SLNB) could be an option in this specific setting that may possibly substitute comprehensive staging, for the identification of patients with lymphatic dissemination.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-016-5731-0</identifier><identifier>PMID: 28058558</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biopsy ; Cancer ; Chemical Sciences ; Classification ; Cohort analysis ; Endometrial cancer ; Endometrial Neoplasms - pathology ; Endometrial Neoplasms - surgery ; Endometrium ; Female ; Follow-Up Studies ; Gynecologic Oncology ; Humans ; Life Sciences ; Lymph ; Lymph Node Excision ; Lymph nodes ; Lymphatic Metastasis ; Medical Oncology ; Medicinal Chemistry ; Medicine ; Medicine & Public Health ; Metastases ; Middle Aged ; Myometrium ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local - pathology ; Neoplasm Recurrence, Local - surgery ; Neoplasm Staging ; Oncology ; Pelvis ; Prospective Studies ; Radiation therapy ; Risk Factors ; Sentinel Lymph Node Biopsy ; Societies, Medical ; Surgery ; Surgical Oncology ; Survival ; Survival Rate ; Tumors ; Uterus</subject><ispartof>Annals of surgical oncology, 2017-06, Vol.24 (6), p.1660-1666</ispartof><rights>Society of Surgical Oncology 2017</rights><rights>Annals of Surgical Oncology is a copyright of Springer, 2017.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c406t-d581b7470bb106bfaa7093ee52135f0332d95d925f6706c6a72b6fa8a2ee431e3</citedby><cites>FETCH-LOGICAL-c406t-d581b7470bb106bfaa7093ee52135f0332d95d925f6706c6a72b6fa8a2ee431e3</cites><orcidid>0000-0003-4292-938X ; 0000-0003-4355-7012 ; 0000-0001-9465-0335 ; 0000-0002-3824-572X ; 0000-0002-9149-1663</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-016-5731-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-016-5731-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28058558$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://univ-rennes.hal.science/hal-01543368$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Ouldamer, L.</creatorcontrib><creatorcontrib>Bendifallah, S.</creatorcontrib><creatorcontrib>Body, G.</creatorcontrib><creatorcontrib>Canlorbe, G.</creatorcontrib><creatorcontrib>Touboul, C.</creatorcontrib><creatorcontrib>Graesslin, O.</creatorcontrib><creatorcontrib>Raimond, E.</creatorcontrib><creatorcontrib>Collinet, P.</creatorcontrib><creatorcontrib>Coutant, C.</creatorcontrib><creatorcontrib>Lavoué, V.</creatorcontrib><creatorcontrib>Lévêque, J.</creatorcontrib><creatorcontrib>Daraï, E.</creatorcontrib><creatorcontrib>Ballester, M.</creatorcontrib><creatorcontrib>Groupe de Recherche FRANCOGYN</creatorcontrib><creatorcontrib>For the Groupe de Recherche FRANCOGYN</creatorcontrib><title>Call for Surgical Nodal Staging in Women with ESMO/ESGO/ESTRO High–Intermediate Risk Endometrial Cancer: A Multicentre Cohort Analysis from the FRANCOGYN Study Group</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
The European Society of Medical Oncology (ESMO)/European Society of Gynaecological Oncology (ESGO)/European Society for Radiotherapy & Oncology (ESTRO) classification for endometrial cancer (EC) now includes a high–intermediate risk (HIR) group of recurrence due to the adverse prognostic role of lymphovascular space involvement (LVSI) and grade 3 for women at intermediate risk. However, optimal surgical staging, and especially the place of lymphadenectomy, remains to be elucidated. We aimed to establish whether systematic nodal staging should be part of surgical staging for women with HIR EC.
Methods
We abstracted from a prospectively maintained multicentre database the data of 181 women with HIR EC based on uterine factors (endometrioid type 1, grade 1–2 tumors with deep (≥50%) myometrial invasion and unequivocally positive LVSI, and those with grade 3 tumors with <50% myometrial invasion regardless of LVSI status), who received primary surgical treatment between January 2001 and December 2013. We recorded frequency of lymph node (LN) metastases in those who underwent nodal staging. The secondary outcomes were overall survival and recurrence patterns.
Results
Overall, 145 (80.1%) women underwent nodal staging consisting of at least pelvic lymphadenectomy. Of these, 62 (42.7%) had LN disease (9.7% with micrometastases). The respective 5-year overall survival rates according to LN status were 85.0% (95% confidence interval [CI] 76.5–91.4), 71.8% (95% CI 61.9–80.4) and 36.0% (95% CI 26.6–46.2) for women with negative LN, positive LN, and unstaged (
p
= 0.047). Unstaged women were more likely to experience nodal recurrence than surgically staged/LN negative women (
p
= 0.05).
Conclusions
Systematic nodal staging should be part of surgical staging for women with apparent ESMO/ESGO/ESTRO HIR EC. Sentinel LN biopsy (SLNB) could be an option in this specific setting that may possibly substitute comprehensive staging, for the identification of patients with lymphatic dissemination.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biopsy</subject><subject>Cancer</subject><subject>Chemical Sciences</subject><subject>Classification</subject><subject>Cohort analysis</subject><subject>Endometrial cancer</subject><subject>Endometrial Neoplasms - pathology</subject><subject>Endometrial Neoplasms - surgery</subject><subject>Endometrium</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gynecologic Oncology</subject><subject>Humans</subject><subject>Life Sciences</subject><subject>Lymph</subject><subject>Lymph Node Excision</subject><subject>Lymph nodes</subject><subject>Lymphatic Metastasis</subject><subject>Medical Oncology</subject><subject>Medicinal Chemistry</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Middle Aged</subject><subject>Myometrium</subject><subject>Neoplasm Invasiveness</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Pelvis</subject><subject>Prospective Studies</subject><subject>Radiation therapy</subject><subject>Risk Factors</subject><subject>Sentinel Lymph Node Biopsy</subject><subject>Societies, Medical</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>Tumors</subject><subject>Uterus</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kUFu1DAUhiMEoqVwADbIEhtYhNpx7Djsomg6U2k6I80UIVaWkzgZl8QebAc0O-7AIbgXJ8FRSoWQ2Dxbz9_7_T_9UfQSwXcoScmlQzDFaQwRjUmGUQwfReeIhE5KGXoc7pCyOE8oOYueOXcHIcowJE-js4RBwghh59HPUvQ9aI0F-9F2qhY92Jgm1L0XndIdUBp8NIPU4JvyB7DY32wvF_vlVG53W7BS3eHX9x_X2ks7yEYJL8FOuc9goZsw5a0KUqXQtbTvQQFuxt6rWmpvJSjNwVgPCi36k1MOtNYMwB8kuNoVm3K7_LQJHsbmBJbWjMfn0ZNW9E6-uD8vog9Xi9tyFa-3y-uyWMd1CqmPG8JQlaUZrKqwfNUKkcEcS0kShEkLMU6anDR5QlqaQVpTkSUVbQUTiZQpRhJfRG9n3YPo-dGqQdgTN0LxVbHmUw8ikmJM2VcU2Dcze7Tmyyid54Nytex7oaUZHUeMUJIjynBAX_-D3pnRhtUnKs8pyhjMAoVmqrbGOSvbBwcI8ilxPiceTFA-Jc5hmHl1rzxWIYGHiT8RByCZAReedCftX1__V_U3wnK0yQ</recordid><startdate>20170601</startdate><enddate>20170601</enddate><creator>Ouldamer, L.</creator><creator>Bendifallah, S.</creator><creator>Body, G.</creator><creator>Canlorbe, G.</creator><creator>Touboul, C.</creator><creator>Graesslin, O.</creator><creator>Raimond, E.</creator><creator>Collinet, P.</creator><creator>Coutant, C.</creator><creator>Lavoué, V.</creator><creator>Lévêque, J.</creator><creator>Daraï, E.</creator><creator>Ballester, M.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><general>Springer Verlag</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0003-4292-938X</orcidid><orcidid>https://orcid.org/0000-0003-4355-7012</orcidid><orcidid>https://orcid.org/0000-0001-9465-0335</orcidid><orcidid>https://orcid.org/0000-0002-3824-572X</orcidid><orcidid>https://orcid.org/0000-0002-9149-1663</orcidid></search><sort><creationdate>20170601</creationdate><title>Call for Surgical Nodal Staging in Women with ESMO/ESGO/ESTRO High–Intermediate Risk Endometrial Cancer: A Multicentre Cohort Analysis from the FRANCOGYN Study Group</title><author>Ouldamer, L. ; Bendifallah, S. ; Body, G. ; Canlorbe, G. ; Touboul, C. ; Graesslin, O. ; Raimond, E. ; Collinet, P. ; Coutant, C. ; Lavoué, V. ; Lévêque, J. ; Daraï, E. ; Ballester, M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c406t-d581b7470bb106bfaa7093ee52135f0332d95d925f6706c6a72b6fa8a2ee431e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biopsy</topic><topic>Cancer</topic><topic>Chemical Sciences</topic><topic>Classification</topic><topic>Cohort analysis</topic><topic>Endometrial cancer</topic><topic>Endometrial Neoplasms - pathology</topic><topic>Endometrial Neoplasms - surgery</topic><topic>Endometrium</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gynecologic Oncology</topic><topic>Humans</topic><topic>Life Sciences</topic><topic>Lymph</topic><topic>Lymph Node Excision</topic><topic>Lymph nodes</topic><topic>Lymphatic Metastasis</topic><topic>Medical Oncology</topic><topic>Medicinal Chemistry</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Middle Aged</topic><topic>Myometrium</topic><topic>Neoplasm Invasiveness</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Recurrence, Local - surgery</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Pelvis</topic><topic>Prospective Studies</topic><topic>Radiation therapy</topic><topic>Risk Factors</topic><topic>Sentinel Lymph Node Biopsy</topic><topic>Societies, Medical</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival</topic><topic>Survival Rate</topic><topic>Tumors</topic><topic>Uterus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ouldamer, L.</creatorcontrib><creatorcontrib>Bendifallah, S.</creatorcontrib><creatorcontrib>Body, G.</creatorcontrib><creatorcontrib>Canlorbe, G.</creatorcontrib><creatorcontrib>Touboul, C.</creatorcontrib><creatorcontrib>Graesslin, O.</creatorcontrib><creatorcontrib>Raimond, E.</creatorcontrib><creatorcontrib>Collinet, P.</creatorcontrib><creatorcontrib>Coutant, C.</creatorcontrib><creatorcontrib>Lavoué, V.</creatorcontrib><creatorcontrib>Lévêque, J.</creatorcontrib><creatorcontrib>Daraï, E.</creatorcontrib><creatorcontrib>Ballester, M.</creatorcontrib><creatorcontrib>Groupe de Recherche FRANCOGYN</creatorcontrib><creatorcontrib>For the Groupe de Recherche FRANCOGYN</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ouldamer, L.</au><au>Bendifallah, S.</au><au>Body, G.</au><au>Canlorbe, G.</au><au>Touboul, C.</au><au>Graesslin, O.</au><au>Raimond, E.</au><au>Collinet, P.</au><au>Coutant, C.</au><au>Lavoué, V.</au><au>Lévêque, J.</au><au>Daraï, E.</au><au>Ballester, M.</au><aucorp>Groupe de Recherche FRANCOGYN</aucorp><aucorp>For the Groupe de Recherche FRANCOGYN</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Call for Surgical Nodal Staging in Women with ESMO/ESGO/ESTRO High–Intermediate Risk Endometrial Cancer: A Multicentre Cohort Analysis from the FRANCOGYN Study Group</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2017-06-01</date><risdate>2017</risdate><volume>24</volume><issue>6</issue><spage>1660</spage><epage>1666</epage><pages>1660-1666</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
The European Society of Medical Oncology (ESMO)/European Society of Gynaecological Oncology (ESGO)/European Society for Radiotherapy & Oncology (ESTRO) classification for endometrial cancer (EC) now includes a high–intermediate risk (HIR) group of recurrence due to the adverse prognostic role of lymphovascular space involvement (LVSI) and grade 3 for women at intermediate risk. However, optimal surgical staging, and especially the place of lymphadenectomy, remains to be elucidated. We aimed to establish whether systematic nodal staging should be part of surgical staging for women with HIR EC.
Methods
We abstracted from a prospectively maintained multicentre database the data of 181 women with HIR EC based on uterine factors (endometrioid type 1, grade 1–2 tumors with deep (≥50%) myometrial invasion and unequivocally positive LVSI, and those with grade 3 tumors with <50% myometrial invasion regardless of LVSI status), who received primary surgical treatment between January 2001 and December 2013. We recorded frequency of lymph node (LN) metastases in those who underwent nodal staging. The secondary outcomes were overall survival and recurrence patterns.
Results
Overall, 145 (80.1%) women underwent nodal staging consisting of at least pelvic lymphadenectomy. Of these, 62 (42.7%) had LN disease (9.7% with micrometastases). The respective 5-year overall survival rates according to LN status were 85.0% (95% confidence interval [CI] 76.5–91.4), 71.8% (95% CI 61.9–80.4) and 36.0% (95% CI 26.6–46.2) for women with negative LN, positive LN, and unstaged (
p
= 0.047). Unstaged women were more likely to experience nodal recurrence than surgically staged/LN negative women (
p
= 0.05).
Conclusions
Systematic nodal staging should be part of surgical staging for women with apparent ESMO/ESGO/ESTRO HIR EC. Sentinel LN biopsy (SLNB) could be an option in this specific setting that may possibly substitute comprehensive staging, for the identification of patients with lymphatic dissemination.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>28058558</pmid><doi>10.1245/s10434-016-5731-0</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-4292-938X</orcidid><orcidid>https://orcid.org/0000-0003-4355-7012</orcidid><orcidid>https://orcid.org/0000-0001-9465-0335</orcidid><orcidid>https://orcid.org/0000-0002-3824-572X</orcidid><orcidid>https://orcid.org/0000-0002-9149-1663</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2017-06, Vol.24 (6), p.1660-1666 |
| issn | 1068-9265 1534-4681 |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_hal_01543368v1 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Aged, 80 and over Biopsy Cancer Chemical Sciences Classification Cohort analysis Endometrial cancer Endometrial Neoplasms - pathology Endometrial Neoplasms - surgery Endometrium Female Follow-Up Studies Gynecologic Oncology Humans Life Sciences Lymph Lymph Node Excision Lymph nodes Lymphatic Metastasis Medical Oncology Medicinal Chemistry Medicine Medicine & Public Health Metastases Middle Aged Myometrium Neoplasm Invasiveness Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - surgery Neoplasm Staging Oncology Pelvis Prospective Studies Radiation therapy Risk Factors Sentinel Lymph Node Biopsy Societies, Medical Surgery Surgical Oncology Survival Survival Rate Tumors Uterus |
| title | Call for Surgical Nodal Staging in Women with ESMO/ESGO/ESTRO High–Intermediate Risk Endometrial Cancer: A Multicentre Cohort Analysis from the FRANCOGYN Study Group |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-23T09%3A09%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_hal_p&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Call%20for%20Surgical%20Nodal%20Staging%20in%20Women%20with%20ESMO/ESGO/ESTRO%20High%E2%80%93Intermediate%20Risk%20Endometrial%20Cancer:%20A%20Multicentre%20Cohort%20Analysis%20from%20the%20FRANCOGYN%20Study%20Group&rft.jtitle=Annals%20of%20surgical%20oncology&rft.au=Ouldamer,%20L.&rft.aucorp=Groupe%20de%20Recherche%20FRANCOGYN&rft.date=2017-06-01&rft.volume=24&rft.issue=6&rft.spage=1660&rft.epage=1666&rft.pages=1660-1666&rft.issn=1068-9265&rft.eissn=1534-4681&rft_id=info:doi/10.1245/s10434-016-5731-0&rft_dat=%3Cproquest_hal_p%3E1899617807%3C/proquest_hal_p%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1899617807&rft_id=info:pmid/28058558&rfr_iscdi=true |